Provider Demographics
NPI:1881932804
Name:HESS, GEROME EVERETT (MSN, NP)
Entity type:Individual
Prefix:
First Name:GEROME
Middle Name:EVERETT
Last Name:HESS
Suffix:
Gender:M
Credentials:MSN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 NORTHBOUND GRATIOT AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-2301
Mailing Address - Country:US
Mailing Address - Phone:586-783-2950
Mailing Address - Fax:586-690-4333
Practice Address - Street 1:100 NORTHBOUND GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-2301
Practice Address - Country:US
Practice Address - Phone:586-783-2950
Practice Address - Fax:586-690-4333
Is Sole Proprietor?:No
Enumeration Date:2013-01-25
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704199017363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner