Provider Demographics
NPI:1801315601
Name:ANUMBA, JULIE (RN, MSH)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:ANUMBA
Suffix:
Gender:F
Credentials:RN, MSH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15800 W MCNICHOLS RD STE 233
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-3570
Mailing Address - Country:US
Mailing Address - Phone:313-270-4550
Mailing Address - Fax:
Practice Address - Street 1:15800 WEST MCNICHOLS ROAD
Practice Address - Street 2:#233
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235
Practice Address - Country:US
Practice Address - Phone:313-270-4550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704212522163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse