Provider Demographics
NPI:1083086482
Name:ALBERT, JAMILA (AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:JAMILA
Middle Name:
Last Name:ALBERT
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30225 TIMBERIDGE CIR
Mailing Address - Street 2:APT 102
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-5440
Mailing Address - Country:US
Mailing Address - Phone:517-896-4526
Mailing Address - Fax:
Practice Address - Street 1:28711 8 MILE RD STE C
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-2041
Practice Address - Country:US
Practice Address - Phone:248-474-4590
Practice Address - Fax:248-888-9127
Is Sole Proprietor?:No
Enumeration Date:2015-10-24
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704272332363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health