Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 4704176316 | MI |
N | 363LG0600X | Nurse Practitioner - Gerontology | 4704176316 | MI |
NPI | 1023326881 |
---|---|
Provider Name | Mrs. Bernadette Sarah Below |
First Address | Troy, MI 48083-2374 |
Second Address | Troy, MI 48083-2374 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2010 |
Last Update Date | 05/01/2019 |