Marlene Louise Petrovich, M.S.N.

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

4704100811 Issued in MI

Practice address

23050 West Rd
Suite210
Brownstown TWP, MI 48183-1472

Phone

(734) 362-7000

NPI assigned

Apr 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: mpetrovich60185@direct.hfhs.org

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1750404612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 FORT ST",
            "address_2": "SUITE D ATTN DENISE",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481832040",
            "telephone_number": "734-391-3057",
            "fax_number": "734-391-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23050 WEST RD",
            "address_2": "SUITE210",
            "city": "BROWNSTOWN TWP",
            "state": "MI",
            "postal_code": "481831472",
            "telephone_number": "734-362-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROVICH",
        "first_name": "MARLENE",
        "middle_name": "LOUISE",
        "credential": "M.S.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-07",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MI",
            "license": "4704100811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI HENRY FORD WYANDOTTE",
            "identifier": "1144634403",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0H28865",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cathy A Pacheco
• Armi Isabel Panlasigue, PT
• Dharaben Patel
• Mayur Patel, M.D.
• Thomas John Petrou, MD
• Carolyn Pilzninski, NP
• Isadora Porter-Hill, MD
• Powell Dental PLLC
• Kiera Lorelle Powell, DDS
• Tyler Scott Powell, DDS

• Women's Health Nurse Practitioner in Brownstown TWP, MI
• Providers in Brownstown TWP, MI by specialty
• Women's Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; 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.