Elan Vitale Healthy Living Solutions
Organization Active NPI Nurse Practitioner · Dearborn HTS, MI
NPI 1982107140 · NPPES record last updated Mar 14, 2018
Key facts
- NPI
- 1982107140
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 4704170920 (MI)
- Legal business name
- ELAN VITALE HEALTHY LIVING SOLUTIONS
- Practice address
- 27247 Joy Rd
Dearborn HTS, MI 48127-1022 - Phone
- (248) 667-6307
- NPI assigned
- Mar 14, 2018
- Organization subpart
- No
Authorized official
- Name
- Jackie Duncan, PMHNP
- Title
- Nurse Practitioner
- Phone
- (248) 667-2531
Practitioners 1
National Provider Directory
Locations
27247 Joy Rd
Dearborn Hts, MI 48127
Phone (248) 667-6307
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner |
363L00000X | 4704170920 | MI | Yes |
Addresses
Primary practice location
27247 Joy Rd
Dearborn HTS, MI 48127-1022
Mailing address
27247 Joy Rd
Dearborn HTS, MI 48127-1022
Other providers in Dearborn HTS, MI
- Irving Blau
- Body in Motion LLC
- Christopher C Caudell
- Sarojini H Desai
- Dr Beydoun and Associates, Inc
- Fatima Services Inc.
- First Choice Urgent Care PC
- Glory Visiting Physician PC.
- Good Care Home Care Inc
- Thomas Melvin Guina
All providers in Dearborn HTS, MI · 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 Mar 14, 2018. 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.