Provider Demographics
NPI:1750902755
Name:POSEY, THERESA ANN (RMA)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:ANN
Last Name:POSEY
Suffix:
Gender:F
Credentials:RMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8470 PARSHALLVILLE RD
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-9211
Mailing Address - Country:US
Mailing Address - Phone:810-210-8167
Mailing Address - Fax:810-632-6890
Practice Address - Street 1:8470 PARSHALLVILLE RD
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-9211
Practice Address - Country:US
Practice Address - Phone:810-210-8167
Practice Address - Fax:810-632-6890
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1096755Medicaid