Provider Demographics
NPI:1801421953
Name:WOELKE, VERONICA (NP)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:WOELKE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:
Other - Last Name:TALEVSKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:G3494 BEECHER RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-2735
Mailing Address - Country:US
Mailing Address - Phone:519-996-4378
Mailing Address - Fax:810-768-1171
Practice Address - Street 1:3581 W 13 MILE RD STE BCC
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6710
Practice Address - Country:US
Practice Address - Phone:248-551-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-10
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704325973363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily