Louella Canty
Individual provider Active NPI Driver · Detroit, MI
NPI 1134556749 · NPPES record last updated Sep 8, 2016
Key facts
- NPI
- 1134556749
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- L2574 (MI)
- Practice address
- 18269 Appoline St
Detroit, MI 48235-1451 - Phone
- (248) 236-5353
- Fax
- (248) 236-5354
- NPI assigned
- Sep 27, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| L2574 | MI | MD | Driver |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Transportation Provider Network LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | L2574 | MI | Yes |
Addresses
Primary practice location
18269 Appoline St
Detroit, MI 48235-1451
Mailing address
18269 Appoline St
Detroit, MI 48235-1451
Phone (248) 236-5353
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 Sep 8, 2016. 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.