Provider Demographics
NPI:1831868017
Name:HESS, PROMITA C (MSN, APRN, AGACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:PROMITA
Middle Name:C
Last Name:HESS
Suffix:
Gender:F
Credentials:MSN, APRN, AGACNP-BC
Other - Prefix:MISS
Other - First Name:PROMITA
Other - Middle Name:
Other - Last Name:CHAKRABORTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, APRN, AGACNP-BC
Mailing Address - Street 1:3621 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1633
Mailing Address - Country:US
Mailing Address - Phone:734-647-5299
Mailing Address - Fax:
Practice Address - Street 1:1500 E MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5000
Practice Address - Country:US
Practice Address - Phone:734-936-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-10
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704319407363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care