Provider Demographics
NPI:1700207081
Name:CAUNT, THERESE (RN, BSN)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:
Last Name:CAUNT
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5022 TIMBERWAY TRL
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-4470
Mailing Address - Country:US
Mailing Address - Phone:248-214-4852
Mailing Address - Fax:
Practice Address - Street 1:6803 DIXIE HWY STE 2
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-5101
Practice Address - Country:US
Practice Address - Phone:248-625-5143
Practice Address - Fax:866-390-8027
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704221485163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse