Provider Demographics
NPI:1407315062
Name:CERESNIE, MARGARET M (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:M
Last Name:CERESNIE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13720 HART ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-1175
Mailing Address - Country:US
Mailing Address - Phone:586-322-4554
Mailing Address - Fax:
Practice Address - Street 1:3510 MIDDLEBURY LN
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48301-4068
Practice Address - Country:US
Practice Address - Phone:248-225-2965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704299161163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse