Houda Abdallah

Individual provider Active NPI Family Nurse Practitioner · Oak Park, MI

NPI 1811524655 · NPPES record last updated Mar 23, 2020

Key facts

NPI
1811524655
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
4704326779NSA20046 (MI)
Practice address
24661 Coolidge Hwy
Oak Park, MI 48237-1449
Phone
(248) 398-4000
NPI assigned
Mar 23, 2020
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)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704326779NSA20046MIMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LF0000X 4704326779NSA20046 MI Yes

Addresses

Primary practice location

24661 Coolidge Hwy
Oak Park, MI 48237-1449

Mailing address

26289 Sheahan Dr
Dearborn Heights, MI 48127-4117
Phone (313) 658-7778

Other practice location 1

26289 Sheahan Dr
Dearborn Heights, MI 48127-4117
Phone (313) 658-7778

Other providers in Oak Park, MI

All providers in Oak Park, MI · Family Nurse Practitioner in Michigan

Sources for this page

Verify at the official NPI Registry.