Provider Demographics
NPI:1578974549
Name:SCHLOFF, BECKY
Entity Type:Individual
Prefix:MS
First Name:BECKY
Middle Name:
Last Name:SCHLOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 CRESTVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48390-3940
Mailing Address - Country:US
Mailing Address - Phone:248-605-5854
Mailing Address - Fax:
Practice Address - Street 1:323 CRESTVIEW BLVD
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48390-3940
Practice Address - Country:US
Practice Address - Phone:248-605-5854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI46-2569124163WA2000X, 164W00000X, 164X00000X, 372500000X, 374U00000X
372600000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No164X00000XNursing Service ProvidersLicensed Vocational Nurse
No372500000XNursing Service Related ProvidersChore Provider
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide