MARY JANE FAVOT NP NPI 1043246564

NPI Information

NPI: 1043246564
Provider Name: MARY JANE FAVOT, NP
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

Address:
15400 MICHIGAN AVE
SUITE ONE
DEARBORN, MI
ZIP 48126
Phone: (313) 584-3359
Get Directions

Mary Jane Favot, NP is a gerontology nurse practitioner in Dearborn, MI. Mary Jane Favot, NP NPI is 1043246564. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

15400 MICHIGAN AVE
SUITE ONE
DEARBORN, MI
ZIP 48126-491
Phone: (313) 584-3359
Fax: (313) 584-1729

The enumeration date for this NPI number is 6/25/2006 and was last updated on 10/6/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LG0600X	Nurse Practitioner	Gerontology	109477	MICHIGAN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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