Individual
MRS. PAULA JANE STOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, FNP-BC
Contact information
Practice address
18101 OAKWOOD BLVD, ISU OBSERVATION UNIT, DEARBORN, MI 48124-4089
(313) 982-5770
(313) 982-5771
Mailing address
38935 ANN ARBOR RD, LIVONIA, MI 48150-3397
(734) 632-0175
(734) 632-0182
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704114321
MI
363LF0000X
Family Nurse Practitioner
4704114321
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12315347
CAQH
MI
Enumeration date
11/02/2011
Last updated
09/09/2013
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