Mr. Jerry Idiculla Chandy
Nurse Practitioner - Adult Health
1675 Kingsway Ct Ste 1
Trenton
, Michigan 48183-1958
Mr. Jerry Idiculla Chandy
Nurse Practitioner - Adult Health
1675 Kingsway Ct Ste 1
Trenton
, Michigan 48183-1958
(734) 676-8530
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About
Features
Specialties
- Nurse Practitioner - Adult Health
Languages spoken
- English
Location
First Address
- Mr. Jerry Idiculla Chandy
- 1675 Kingsway Ct Ste 1
- Trenton, MI
- Zip : 48183-1958
- Phone : (734) 676-8530
Second Address
- Mr. Jerry Idiculla Chandy
- 1675 Kingsway Ct Ste 1
- Trenton, MI
- Zip : 48183-1958
- Phone : (734) 676-8530
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LA2200X | Nurse Practitioner - Adult Health | 4704276954 | MI |
National Provider Identifier
| NPI | 1023447695 |
|---|---|
| Provider Name | Mr. Jerry Idiculla Chandy |
| First Address | Trenton, MI 48183-1958 |
| Second Address | Trenton, MI 48183-1958 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/11/2013 |
| Last Update Date | 05/11/2013 |
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.