Jennifer Marie Ahlquist, MSN, CNP, ANP-BC
Individual provider Active NPI Adult Health Nurse Practitioner · Clawson, MI
NPI 1770830366 · NPPES record last updated Aug 14, 2012
Key facts
- NPI
- 1770830366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 4704284307 (MI)
- Practice address
- 555 W 14 Mile Rd
Suite 100
Clawson, MI 48017-3100 - Phone
- (248) 655-1400
- Fax
- (248) 655-2646
- NPI assigned
- Aug 14, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704284307 | MI | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Woodward Internal Medicine Associates, P.C. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 4704284307 | MI | Yes |
Addresses
Primary practice location
555 W 14 Mile Rd
Suite 100
Clawson, MI 48017-3100
Mailing address
555 W 14 Mile Rd
Suite 100
Clawson, MI 48017-3100
Phone (248) 655-1400
Other providers in Clawson, MI
- Purvesh G Adhyaru
- Megan Lynn Adriaens
- Advanced Ophthalmology Associates PLC
- Aesthetic Smiles and Implants
- Alexandra Maria Agapiou
- Alexander Malayev MD PC
- Sarah Mariyan Ali
- Louise S. Aloe
- Farah Alsana
- Always Home Health Inc
All providers in Clawson, MI · Adult Health Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.