Charlene Brockway

Individual provider Active NPI Home Health Registered Nurse · Dundee, MI

NPI 1689263295 · NPPES record last updated Jan 18, 2021

Key facts

NPI
1689263295
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Registered Nurse 163WH0200X
License
4704308738 (MI)
Practice address
100 Powell Dr
Dundee, MI 48131-8644
Phone
(517) 266-2481
NPI assigned
Jan 18, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4704308738MIMDHome Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 4704308738 MI Yes

Addresses

Primary practice location

100 Powell Dr
Dundee, MI 48131-8644

Mailing address

100 Powell Dr
Dundee, MI 48131-8644

Other providers in Dundee, MI

All providers in Dundee, MI · Home Health Registered Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.