Provider Demographics
NPI:1265033450
Name:WHEELER, ANNA KARIN (NP-C)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:KARIN
Last Name:WHEELER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1537 MONROE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2842
Mailing Address - Country:US
Mailing Address - Phone:133-592-1003
Mailing Address - Fax:
Practice Address - Street 1:1537 MONROE ST STE 100
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2842
Practice Address - Country:US
Practice Address - Phone:313-359-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704352577363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily