Individual
MS. MELISSA SUSAN BOOTHROYD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
23200 RYAN RD, FITZGERALD HEALTH CENTER, WARREN, MI 48091-4551
(586) 759-9070
Mailing address
29085 OAK POINT DR, FARMINGTON HILLS, MI 48331-2715
(248) 489-8632
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704121618
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4667898
—
MI
Enumeration date
10/31/2006
Last updated
07/08/2007
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