Individual
SUSAN BRANDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
22301 KELLY RD, EASTPOINTE, MI 48021-2619
(586) 443-5588
(586) 443-5538
Mailing address
22301 KELLY RD, EASTPOINTE, MI 48021-2619
(586) 443-5588
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704120861
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0865316
BCBS PIN NUMBER
MI
01
—
0E012730
BCBSM GROUP NUMBER
MI
05
—
1629006929
—
MI
Enumeration date
06/28/2006
Last updated
07/21/2008
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