TRAVELL DENEISE JOHNSON-PETTWAY RN NPI 1528792777

NPI Information

NPI: 1528792777
Provider Name: TRAVELL DENEISE JOHNSON-PETTWAY, RN
Classification: Registered Nurse - 163WA2000X
Entity Type: Individual

Specialization: Administrator

Address:
4646 JOHN R ST
DETROIT, MI
ZIP 48201
Phone: (313) 576-1000
Get Directions

Travell Deneise Johnson-pettway, RN is an administrator registered nurse in Detroit, MI. Travell Deneise Johnson-pettway, RN NPI is 1528792777. 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:

4646 JOHN R ST
DETROIT, MI
ZIP 48201-916
Phone: (313) 576-1000

The enumeration date for this NPI number is 7/13/2022 and was last updated on 7/13/2022.

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	163WA2000X	Registered Nurse	Administrator	4704202831	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: 5/5/2024

NPI Synchronization or Removal

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