Individual
MARLENE LOUISE PETROVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.N.
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
4704100811
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H28865
BLUE CROSS
MI
01
—
1144634403
GROUP NPI HENRY FORD WYANDOTTE
—
Enumeration date
04/07/2007
Last updated
02/22/2017
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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