Active NPI
Emma Kristine Mandouh, NP
- Nurse Practitioner
- Warren, MI
National Provider Identifier
1285592162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4704362447
- Practice address
- 21230 Dequindre Rd
Warren, MI 48091-2279 - Phone
- (586) 427-1000
- NPI assigned
- Jan 12, 2026
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704362447 | MI | |
| Nurse Practitioner | 363L00000X | 4704362447 | MI | Primary |
Addresses
Primary practice location
21230 Dequindre Rd
Warren, MI 48091-2279
Mailing address
21230 Dequindre Rd
Warren, MI 48091-2279
Other names 1
- Emma Kristine Taylor
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- University of Michigan Medical School, 2026
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4800 S Saginaw St
Flint, MI 48507-2677
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704362447 | MI | MD | General Practice Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1768176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784592000000",
"number": "1285592162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21230 DEQUINDRE RD",
"city": "WARREN",
"state": "MI",
"postal_code": "480912279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21230 DEQUINDRE RD",
"city": "WARREN",
"state": "MI",
"postal_code": "480912279",
"telephone_number": "586-427-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDOUH",
"first_name": "EMMA",
"middle_name": "KRISTINE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-01-12",
"last_updated": "2026-07-21",
"certification_date": "2026-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MI",
"license": "4704362447",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704362447",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "EMMA",
"last_name": "TAYLOR",
"middle_name": "KRISTINE",
"credential": "NP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.