Provider Demographics
NPI:1326471764
Name:DREW, TIMIKO LEI (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:TIMIKO
Middle Name:LEI
Last Name:DREW
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
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Mailing Address - Street 1:220 MAIN SAIL CT
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48207-5008
Mailing Address - Country:US
Mailing Address - Phone:313-587-3087
Mailing Address - Fax:248-286-6255
Practice Address - Street 1:27177 LAHSER RD STE 201
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-8468
Practice Address - Country:US
Practice Address - Phone:248-895-8562
Practice Address - Fax:248-286-6255
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-20
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704177492363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health