Individual
OMOLOLA BEAIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
41800 W 11 MILE RD STE 109, NOVI, MI 48375-1818
(248) 660-1220
Mailing address
PO BOX 746720, ATLANTA, GA 30374-6720
(312) 733-9730
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704298788
MI
363LP2300X
Primary Care Nurse Practitioner
28207413A
IN
Other
Enumeration date
10/24/2020
Last updated
02/11/2025
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