Restoration Health LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704205118 Issued in MI

Legal business name

RESTORATION HEALTH LLC

Practice address

17751 E Warren Ave
Detroit, MI 48224-1329

Phone

(313) 744-2164

NPI assigned

Oct 14, 2016

Organization subpart

No

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

Authorized official

Name

Dequindra Quinn, RN NP-C

Title

Owner

Phone

(313) 744-2164

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1476403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476403200000",
    "number": "1710438775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17751 E WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482241329",
            "telephone_number": "313-744-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17751 E WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482241329",
            "telephone_number": "313-744-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-14",
        "last_updated": "2016-10-14",
        "status": "A",
        "authorized_official_last_name": "QUINN",
        "authorized_official_first_name": "DEQUINDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-744-2164",
        "authorized_official_credential": "RN NP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704205118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; 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.