Provider Demographics
NPI:1033496955
Name:CONTRERAS, MARCELLI JADE G (NP)
Entity Type:Individual
Prefix:MRS
First Name:MARCELLI
Middle Name:JADE G
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:26901 BEAUMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-0037
Mailing Address - Fax:947-522-0038
Practice Address - Street 1:26901 BEAUMONT BLVD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-3849
Practice Address - Country:US
Practice Address - Phone:947-522-0037
Practice Address - Fax:947-522-0038
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-05
Last Update Date:2023-06-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704202054163W00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse