Individual provider · NPI-1

Elzbieta Wieslawa Baba, DNP

Nurse Practitioner, Family · Southgate, MI

NPI number1255859195

StatusActive

Last updated in NPPESJun 26, 2023

Details

NPI: 1255859195
Entity type: Individual (NPI-1)
Name: Mrs. Elzbieta Wieslawa Baba
Credential: DNP
Sex: Female
Sole proprietor: Yes
Enumeration date: Aug 30, 2017
Certification date: Jun 26, 2023
Last updated: Jun 26, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LF0000X	Nurse Practitioner, Family	4704294575	MI	Yes

Practice location

15450 Northline Rd. Suite 101
Southgate, MI 48195-7952

Phone 734-225-1315 · Fax 877-892-4080

Mailing address

14600 King Rd # A
Riverview, MI 48193-7952

Phone 734-479-7800

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