Active NPI
Eveline Passeno
- General Practice Registered Nurse
- Troy, MI
National Provider Identifier
1396471124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Registered Nurse
- License
- 4704234730
- Practice address
- 1059 Owendale Dr
Troy, MI 48083-1913 - Phone
- (313) 922-2222
- Fax
- (866) 287-5710
- NPI assigned
- Jul 25, 2022
- 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 |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 4704234730 | MI | Primary |
Addresses
Primary practice location
1059 Owendale Dr
Troy, MI 48083-1913
Mailing address
1059 Owendale Dr
Troy, MI 48083-1913
Phone (313) 922-2222
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 |
|---|---|---|---|
| 4704234730 | MI | MD | General Practice Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658707200000",
"number": "1396471124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1059 OWENDALE DR",
"city": "TROY",
"state": "MI",
"postal_code": "480831913",
"telephone_number": "313-922-2222",
"fax_number": "866-287-5710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1059 OWENDALE DR",
"city": "TROY",
"state": "MI",
"postal_code": "480831913",
"telephone_number": "313-922-2222",
"fax_number": "866-287-5710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASSENO",
"first_name": "EVELINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-25",
"last_updated": "2022-07-25",
"certification_date": "2022-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "MI",
"license": "4704234730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.