Provider Demographics
NPI:1922346980
Name:ANIEJURENGHO, TORITSETSE CYNTHIA (NP)
Entity Type:Individual
Prefix:
First Name:TORITSETSE
Middle Name:CYNTHIA
Last Name:ANIEJURENGHO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23219 DEMICK CT
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN
Mailing Address - State:MI
Mailing Address - Zip Code:48134-6019
Mailing Address - Country:US
Mailing Address - Phone:313-598-7529
Mailing Address - Fax:
Practice Address - Street 1:23219 DEMICK CT
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN
Practice Address - State:MI
Practice Address - Zip Code:48134-6019
Practice Address - Country:US
Practice Address - Phone:313-598-7529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-26
Last Update Date:2013-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704263570363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health