Provider Demographics
NPI:1578737730
Name:DENOMME, EILEEN ELIZABETH (CPM)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:ELIZABETH
Last Name:DENOMME
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15477 GROVEDALE ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-4017
Mailing Address - Country:US
Mailing Address - Phone:586-337-0393
Mailing Address - Fax:
Practice Address - Street 1:11111 HALL RD STE 15
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:MI
Practice Address - Zip Code:48317-5711
Practice Address - Country:US
Practice Address - Phone:586-337-0393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
12080015176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife