Individual
DR. DIANE MARIE BURGERMEISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CS
Contact information
Practice address
31487 NORTHWESTERN HWY, SUITE A, FARMINGTON HILLS, MI 48334-2526
(248) 855-1695
Mailing address
31487 NORTHWESTERN HWY, SUITE A, FARMINGTON HILLS, MI 48334-2526
(248) 855-1695
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704095475
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0866234
BCBSM PROVIDER
MI
01
—
126224
VALUE OPTIONS PROVIDER
MI
Enumeration date
07/17/2006
Last updated
07/08/2007
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