Provider Demographics
NPI:1710496682
Name:AJAMI, RANIA (MSN, RN, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:RANIA
Middle Name:
Last Name:AJAMI
Suffix:
Gender:F
Credentials:MSN, RN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2547 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-3013
Mailing Address - Country:US
Mailing Address - Phone:313-791-8300
Mailing Address - Fax:
Practice Address - Street 1:2547 MONROE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-3013
Practice Address - Country:US
Practice Address - Phone:313-791-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-23
Last Update Date:2023-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704272313363LP0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics