Provider Demographics
NPI:1801818943
Name:REMBOR, CAROL LEIGH (MS, APRN, BC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:LEIGH
Last Name:REMBOR
Suffix:
Gender:F
Credentials:MS, APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 S LIVERNOIS RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-2584
Mailing Address - Country:US
Mailing Address - Phone:248-608-8800
Mailing Address - Fax:248-608-2490
Practice Address - Street 1:441 S LIVERNOIS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2584
Practice Address - Country:US
Practice Address - Phone:248-608-8800
Practice Address - Fax:248-608-2490
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704150449364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health