Individual provider Active NPI

Emily Nichole Guldan, FNP, ANCC-BC

  • Family Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1124573373
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704290698 Issued in MI
Practice address
311 Mack Ave
Detroit, MI 48201-2466
Phone
(313) 745-8792
NPI assigned
Aug 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704290698 MI Primary

Addresses

Primary practice location

311 Mack Ave
Detroit, MI 48201-2466

Mailing address

311 Mack Ave
Detroit, MI 48201-2466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180801001026 MI Practitioner - Nurse Practitioner 7618225004 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Macomb Hospital Corporation CurrentSince Jun 24, 2018 Accepting new patients
Henry Ford Macomb Hospital Corporation CurrentSince Jun 24, 2018 Accepting new patients
Henry Ford Macomb Hospital Corporation Current Accepting new patients

Locations

30795 23 Mile Rd
Chesterfield, MI 48047
Phone (586) 421-3000

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1124573373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012466",
            "telephone_number": "313-745-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULDAN",
        "first_name": "EMILY",
        "middle_name": "NICHOLE",
        "credential": "FNP, ANCC-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-17",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704290698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.