Provider Demographics
NPI:1700451952
Name:ABDELRAHMAN, AMEARIA H
Entity Type:Individual
Prefix:
First Name:AMEARIA
Middle Name:H
Last Name:ABDELRAHMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13133 TORRY PINES CT
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-7963
Mailing Address - Country:US
Mailing Address - Phone:313-405-6199
Mailing Address - Fax:
Practice Address - Street 1:13133 TORRY PINES CT
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-7963
Practice Address - Country:US
Practice Address - Phone:313-405-6199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704331082NSA2103D363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care