Missionary Servants of Divine Providence

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704294907 Issued in MI

Legal business name

MISSIONARY SERVANTS OF DIVINE PROVIDENCE

Practice address

26629 Hopkins St
Inkster, MI 48141-3111

Phone

(734) 560-5014

NPI assigned

Mar 10, 2017

Last updated

Mar 10, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Justina Udeagha

Title

President/Administrator

Phone

(734) 560-5014

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489104000000",
    "number": "1245771294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26629 HOPKINS ST",
            "city": "INKSTER",
            "state": "MI",
            "postal_code": "481413111",
            "telephone_number": "734-560-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26629 HOPKINS ST",
            "city": "INKSTER",
            "state": "MI",
            "postal_code": "481413111",
            "telephone_number": "734-560-5014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSIONARY SERVANTS OF DIVINE PROVIDENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-10",
        "last_updated": "2017-03-10",
        "status": "A",
        "authorized_official_last_name": "UDEAGHA",
        "authorized_official_first_name": "JUSTINA",
        "authorized_official_title_or_position": "PRESIDENT/ADMINISTRATOR",
        "authorized_official_telephone_number": "734-560-5014"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704294907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295275584",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Miller
• Milqcare
• Claire Minneboo
• Missionary Daughters of the Eternal Father
• Missionary Servants of Divine Providence
• Euneika Sade Mitchell
• Ahmed Mohamed
• Cherice Moore
• Lache Moore, CHW
• Donyal Moorehead

• Registered Nurse in Inkster, MI
• Providers in Inkster, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.