Vanessa Carol Dennis
Individual provider Active NPI Driver · Detroit, MI
NPI 1700601648 · NPPES record last updated Nov 16, 2024
Key facts
- NPI
- 1700601648
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- D520839108827 (MI)
- Practice address
- 15717 Heyden St
Detroit, MI 48223-1240 - Phone
- (313) 728-2091
- NPI assigned
- Nov 16, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D520839108827 | MI | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | D520839108827 | MI | Yes |
Addresses
Primary practice location
15717 Heyden St
Detroit, MI 48223-1240
Mailing address
15717 Heyden St
Detroit, MI 48223-1240
Phone (313) 728-2091
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.