Individual
DEEPBELLA KHALSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
6777 W MAPLE RD, W BLOOMFIELD, MI 48322-3013
(248) 855-8611
Mailing address
6777 W MAPLE RD, W BLOOMFIELD, MI 48322-3013
(248) 855-8611
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704229460
MI
363LA2100X
Acute Care Nurse Practitioner
Primary
4704229460
MI
Other
Enumeration date
12/31/2012
Last updated
02/12/2021
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