Individual
PALLAV DEKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, AGACNP-BC
Contact information
Practice address
5091 WILLOUGHBY RD, HOLT, MI 48842-1054
(517) 694-2144
(517) 694-7469
Mailing address
804 SERVICE RD STE A109B, EAST LANSING, MI 48824-7015
(517) 694-2144
(517) 694-7469
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704350380
MI
363LG0600X
Gerontology Nurse Practitioner
4704350380
MI
Other
Enumeration date
04/18/2017
Last updated
08/23/2024
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