Active NPI
Adesuwa Iyoha
- Adult Health Nurse Practitioner
- Romulus, MI
National Provider Identifier
1194385500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- AS820317288
- Practice address
- 30509 Halecreek St
Romulus, MI 48174-3224 - Phone
- (734) 992-4894
- Fax
- (734) 221-5850
- NPI assigned
- Jun 18, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | AS820317288 | MI | Primary |
Addresses
Primary practice location
30509 Halecreek St
Romulus, MI 48174-3224
Mailing address
PO Box 3011
Ann Arbor, MI 48106-3011
Phone (734) 846-7884
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 |
|---|---|---|---|
| AS820317288 | MI | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560816000000",
"number": "1194385500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3011",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481063011",
"telephone_number": "734-846-7884",
"fax_number": "734-221-5850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30509 HALECREEK ST",
"city": "ROMULUS",
"state": "MI",
"postal_code": "481743224",
"telephone_number": "734-992-4894",
"fax_number": "734-221-5850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IYOHA",
"first_name": "ADESUWA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-18",
"last_updated": "2019-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MI",
"license": "AS820317288",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Romulus, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.