Mary Jane Favot
Nurse Practitioner - Gerontology
15400 Michigan Ave Suite One
Dearborn
, Michigan 48126-3491
Mary Jane Favot
Nurse Practitioner - Gerontology
15400 Michigan Ave Suite One
Dearborn
, Michigan 48126-3491
(313) 584-1729
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About
Features
Specialties
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Mary Jane Favot
- 15400 Michigan Ave Suite One
- Dearborn, MI
- Zip : 48126-3491
- Fax : (313) 584-1729
- Phone : (313) 584-3359
Second Address
- Mary Jane Favot
- 15400 Michigan Ave Suite One
- Dearborn, MI
- Zip : 48126-3491
- Fax : (313) 584-1729
- Phone : (313) 584-3359
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LG0600X | Nurse Practitioner - Gerontology | 109477 | MI |
National Provider Identifier
| NPI | 1043246564 |
|---|---|
| Provider Name | Mary Jane Favot |
| First Address | Dearborn, MI 48126-3491 |
| Second Address | Dearborn, MI 48126-3491 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/06/2006 |
| Last Update Date | 06/10/2009 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.