Provider Demographics
NPI:1477389724
Name:QUAYOUM, GHUFRANA (NP-C)
Entity type:Individual
Prefix:MRS
First Name:GHUFRANA
Middle Name:
Last Name:QUAYOUM
Suffix:
Gender:
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 1:23010 JULIEANN CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-4076
Mailing Address - Country:US
Mailing Address - Phone:313-523-1719
Mailing Address - Fax:
Practice Address - Street 1:6100 DOROTHY ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48211-1594
Practice Address - Country:US
Practice Address - Phone:313-523-1719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIF05230291363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily