Provider Demographics
NPI:1972187565
Name:ESSA, DENA Y (NP)
Entity Type:Individual
Prefix:
First Name:DENA
Middle Name:Y
Last Name:ESSA
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 1:2454 MONROE ST STE A
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-3038
Mailing Address - Country:US
Mailing Address - Phone:313-562-4100
Mailing Address - Fax:
Practice Address - Street 1:2454 MONROE ST STE A
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-3038
Practice Address - Country:US
Practice Address - Phone:313-562-4100
Practice Address - Fax:313-562-4590
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704297825363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily