MRS. HEATHER EVELYN NYSTROM NNP-BC NPI 1649508854

NPI Information

NPI: 1649508854
Provider Name: MRS. HEATHER EVELYN NYSTROM, NNP-BC
Classification: Nurse Practitioner - 363LN0000X
Entity Type: Individual

Specialization: Neonatal

PECOS Registration: Yes

Address:
2799 W GRAND BLVD
DETROIT, MI
ZIP 48202
Phone: (313) 916-0467
Get Directions

MRS. Heather Evelyn Nystrom, NNP-BC is a neonatal nurse practitioner in Detroit, MI. MRS. Heather Evelyn Nystrom, NNP-BC NPI is 1649508854. 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:

2799 W GRAND BLVD
DETROIT, MI
ZIP 48202-608
Phone: (313) 916-0467
Fax: (313) 916-9485

The NPI 1649508854 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/28/2009 and was last updated on 11/23/2022.

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	363LN0000X	Nurse Practitioner	Neonatal	4704203209	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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