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Individual

NICOLE R BEECHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
26211 CENTRAL PARK BLVD STE 116, LATHRUP VILLAGE, MI 48076-4107
(248) 671-3022
Mailing address
6725 DALY RD UNIT 251503, WEST BLOOMFIELD, MI 48325-3262
(248) 277-6011

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
B260630729782
MI
372500000X
Chore Provider
372600000X
Adult Companion
3747A0650X
Attendant Care Provider
3747P1801X
Personal Care Attendant
374U00000X
Home Health Aide
376K00000X
Nurse's Aide
Primary
MI000055804
MI
405300000X
Prevention Professional
MI000055804
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000055804
STATE OF MICHIGAN
MI
Enumeration date
03/05/2020
Last updated
03/05/2020
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