Provider Demographics
NPI:1932572336
Name:APELA ADVANCED PRACTICE CLINICAL CONSULTANTS
Entity Type:Organization
Organization Name:APELA ADVANCED PRACTICE CLINICAL CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSELYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:OGOLA-MWANGALE
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APN-NP, FNP-C
Authorized Official - Phone:248-636-6058
Mailing Address - Street 1:15700 W 10 MILE RD STE 216
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2143
Mailing Address - Country:US
Mailing Address - Phone:248-893-5206
Mailing Address - Fax:248-432-6541
Practice Address - Street 1:15700 W 10 MILE RD STE 216
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2143
Practice Address - Country:US
Practice Address - Phone:248-893-5206
Practice Address - Fax:248-432-6541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704296484363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty