Provider Demographics
NPI:1124246178
Name:NARAYANAN, NIRMALA (RPH)
Entity type:Individual
Prefix:MRS
First Name:NIRMALA
Middle Name:
Last Name:NARAYANAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:NIRMALA
Other - Middle Name:
Other - Last Name:GURUNATHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24741 TERRA DEL MAR DR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374
Mailing Address - Country:US
Mailing Address - Phone:248-374-9961
Mailing Address - Fax:
Practice Address - Street 1:35884 GRAND RIVER AVENUE
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335
Practice Address - Country:US
Practice Address - Phone:248-474-1717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302030536183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist