Individual
HEATHER MARIE VANVALLIS-MACZKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
1000 HARRINGTON ST, MOUNT CLEMENS, MI 48043-2920
(586) 493-8000
Mailing address
37133 N ARAGONA DR, CLINTON TOWNSHIP, MI 48036-2007
(248) 721-6678
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704334264
MI
363LA2100X
Acute Care Nurse Practitioner
4704334264
MI
363LA2200X
Adult Health Nurse Practitioner
4704334264
MI
363LG0600X
Gerontology Nurse Practitioner
4704334264
MI
Other
Enumeration date
02/25/2021
Last updated
02/25/2021
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