NPI 1649356551 · live from the CMS NPI Registry
Melissa Susan Boothroyd, PNP
Nurse Practitioner, Pediatrics in Warren, MI. National Provider Identifier 1649356551, active.
NPI record
| NPI | 1649356551 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 23200 Ryan Rd, Fitzgerald Health Center, Warren, MI 48091 |
| Practice phone | 586-759-9070 |
| Mailing address | 29085 Oak Point Dr, Farmington Hills, MI 48331 |
| Enumerated | October 31, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 4704121618 (MI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.