Provider Demographics
NPI:1801076328
Name:HOSLER, EMILY BROOKE (APRN, BC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:BROOKE
Last Name:HOSLER
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:BROOKE
Other - Last Name:KEETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:26400 W 12 MILE RD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1700
Mailing Address - Country:US
Mailing Address - Phone:248-208-8787
Mailing Address - Fax:248-208-8788
Practice Address - Street 1:26400 W. 12 MILE ROAD
Practice Address - Street 2:SUITE 170
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1753
Practice Address - Country:US
Practice Address - Phone:248-208-8787
Practice Address - Fax:248-208-8788
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704244707363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner