Provider Demographics
NPI:1639550346
Name:ENOS, JOSEPH DARWIYN (MSN, FNP B-C)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:DARWIYN
Last Name:ENOS
Suffix:
Gender:M
Credentials:MSN, FNP B-C
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:
Other - Last Name:ENOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN, FNP B-C
Mailing Address - Street 1:1560 E MAPLE RD
Mailing Address - Street 2:SUITE 400-CREDENTIALING 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:2015-06-18
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704266426363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily