Provider Demographics
NPI:1255681458
Name:MATHEW, RINU LIJU (CNP)
Entity Type:Individual
Prefix:MS
First Name:RINU
Middle Name:LIJU
Last Name:MATHEW
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:43401 SCHOENHERR RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-1961
Mailing Address - Country:US
Mailing Address - Phone:586-488-3636
Mailing Address - Fax:586-488-3635
Practice Address - Street 1:43401 SCHOENHERR RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-1961
Practice Address - Country:US
Practice Address - Phone:586-488-3636
Practice Address - Fax:586-488-3635
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704253827363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care