Provider Demographics
NPI:1578648945
Name:PYETT, JOCELYN H (MA, APRN, BC)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:H
Last Name:PYETT
Suffix:
Gender:F
Credentials:MA, APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 CLIFFS DR
Mailing Address - Street 2:301B
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-7342
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2890 CARPENTER RD
Practice Address - Street 2:SUITE 1600
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-1100
Practice Address - Country:US
Practice Address - Phone:734-677-0609
Practice Address - Fax:734-677-3072
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704119696163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP1491001Medicare ID - Type UnspecifiedMEDICARE PROVIDER #