Provider Demographics
NPI:1932557113
Name:DENHOLM, DEIRDRE JANE (RN, PMHNP)
Entity Type:Individual
Prefix:MS
First Name:DEIRDRE
Middle Name:JANE
Last Name:DENHOLM
Suffix:
Gender:F
Credentials:RN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5725 WOODWIND DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301-1069
Mailing Address - Country:US
Mailing Address - Phone:248-515-9792
Mailing Address - Fax:
Practice Address - Street 1:1760 S TELEGRAPH RD STE 103
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0180
Practice Address - Country:US
Practice Address - Phone:248-534-5064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704318350363LP0808X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health