Active NPI
Nancy Wanna
- Pharmacist
- Northville, MI
National Provider Identifier
1164053401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302038516
- Practice address
- 44300 5 Mile Rd
Northville, MI 48168-9504 - Phone
- (734) 416-1883
- NPI assigned
- Jan 27, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302038516 | MI | Primary |
Addresses
Primary practice location
44300 5 Mile Rd
Northville, MI 48168-9504
Mailing address
6741 Chelsea BRG
West Bloomfield, MI 48322-3076
Phone (248) 252-3728
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302038516 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580083200000",
"number": "1164053401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6741 CHELSEA BRG",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483223076",
"telephone_number": "248-252-3728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44300 5 MILE RD",
"city": "NORTHVILLE",
"state": "MI",
"postal_code": "481689504",
"telephone_number": "734-416-1883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANNA",
"first_name": "NANCY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-27",
"last_updated": "2020-01-27",
"certification_date": "2020-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302038516",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.