Anne Whitaker
Individual provider Active NPI Registered Nurse · Detroit, MI
NPI 1104411461 · NPPES record last updated Mar 8, 2021
Key facts
- NPI
- 1104411461
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 4704371103 (MI)
- Practice address
- 19750 Burt Rd
Detroit, MI 48219-2078 - Phone
- (313) 531-2500
- NPI assigned
- Mar 8, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704371103 | MI | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704371103 | MI | Yes |
Addresses
Primary practice location
19750 Burt Rd
Detroit, MI 48219-2078
Mailing address
19750 Burt Rd
Detroit, MI 48219-2078
Phone (313) 531-2500
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.