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DANA VITANOVSKI-PETROVSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
15959 HALL RD STE 100, MACOMB, MI 48044-5364
(586) 416-5940
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704269062
MI
363L00000X
Nurse Practitioner
4704269062
MI
363LA2200X
Adult Health Nurse Practitioner
Primary
4704269062
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0861925
BCBSM PIN
MI
01
0F37550
BCBSM GROUP PIN
MI
01
0F38769
BCBSM GROUP NP PIN
MI
05
1043562085
MI
Enumeration date
10/15/2012
Last updated
08/15/2024
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