Provider Demographics
NPI:1629400270
Name:NORWOOD, MARQUETTA YOLANDA (WHNP)
Entity Type:Individual
Prefix:
First Name:MARQUETTA
Middle Name:YOLANDA
Last Name:NORWOOD
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1560 E MAPLE RD
Mailing Address - Street 2:SUITE 400 - CREDENTILAING DEPARTMENT
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1138
Mailing Address - Country:US
Mailing Address - Phone:313-745-4525
Mailing Address - Fax:313-577-3223
Practice Address - Street 1:3901 CHRYSLER DR
Practice Address - Street 2:STE 4A
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2167
Practice Address - Country:US
Practice Address - Phone:313-745-4525
Practice Address - Fax:313-577-3223
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704269201363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health