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Individual

VINCENT DECIANTIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP-C

Contact information

Practice address
30600 TELEGRAPH RD STE 1160, BINGHAM FARMS, MI 48025-4531
(844) 999-0020
(888) 926-1121
Mailing address
7240 CHASE OAKS BLVD, PLANO, TX 75025-5901
(844) 999-0020
(214) 291-5297

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
4704274231
MI
282N00000X
General Acute Care Hospital
4704274231
MI
363LG0600X
Gerontology Nurse Practitioner
Primary
4704274231
MI

Other

Enumeration date
12/02/2015
Last updated
04/21/2026
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