GERIATRIC PSYCHIATRIC SERVICES PLLC NPI 1104063239

NPI Information

  • NPI: 1104063239
  • Provider Name: GERIATRIC PSYCHIATRIC SERVICES PLLC
  • Classification: Nurse Practitioner - 363L00000X
  • Entity Type: Organization
  • Other Name: NURSE PRACTITIONER GROUP
  • Address: 28800 RYAN RD
    SUITE 320
    WARREN, MI
    ZIP 48092
  • Phone: (586) 620-8100

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NPI Details

GERIATRIC PSYCHIATRIC SERVICES PLLC is a nurse practitioner in Warren, MI. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. GERIATRIC PSYCHIATRIC SERVICES PLLC NPI is 1104063239. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Other Name Is Nurse Practitioner Group.

The provider's business location address is:

28800 RYAN RD
SUITE 320
WARREN, MI
ZIP 48092-272
Phone: (586) 620-8100
Fax: (866) 227-7418

The provider's authorized official is Robert A Clemente .
The authorized official title is Manager and has the following contact phone number (586) 620-8100.

The enumeration date for this NPI number is 1/12/2009 and was last updated on 7/25/2024.

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
1363AM0700XPhysician AssistantMedicalNo
2363L00000XNurse PractitionerYes
3364SA2200XClinical Nurse SpecialistAdult HealthNo
4364SP0809XClinical Nurse SpecialistPsychiatric/Mental Health, AdultNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1500F339520OTHERMICHIGANBCBS PIN NUMBER

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: 11/21/2025

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