Individual provider · NPI-1

Charmaine Adegeye

Nurse Practitioner, Psych/Mental Health · Southfield, MI

NPI number1003393695
StatusActive
Last updated in NPPESNov 16, 2023

Details

NPI
1003393695
Entity type
Individual (NPI-1)
Name
Charmaine Adegeye
Sex
Female
Sole proprietor
No
Enumeration date
Jul 26, 2018
Certification date
Nov 16, 2023
Last updated
Nov 16, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0808X Nurse Practitioner, Psych/Mental Health4704240600MIYes
363LF0000X Nurse Practitioner, Family4704240600MI

Practice location

25240 Lahser Rd Ste 2
Southfield, MI 48033-2751

Phone 248-564-1367 · Fax 734-725-6746

Mailing address

45443 Parkdale Dr
Canton, MI 48188-2437

Phone 248-795-3553

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