IMAOBONG IBOKETTE VANDERPOOL NP NPI 1841849544

NPI Information

  • NPI: 1841849544
  • Provider Name: IMAOBONG IBOKETTE VANDERPOOL, NP
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Individual
  • Address: 17256 ROSELAND BLVD
    SOUTHFIELD, MI
    ZIP 48076
  • Phone: (248) 388-0881

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NPI Details

Imaobong Ibokette Vanderpool, NP is a primary care nurse practitioner in Southfield, MI. Imaobong Ibokette Vanderpool, NP NPI is 1841849544. 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:

17256 ROSELAND BLVD
SOUTHFIELD, MI
ZIP 48076-823
Phone: (248) 388-0881

The enumeration date for this NPI number is 9/5/2019 and was last updated on 9/5/2019.

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
1363LP2300XNurse PractitionerPrimary Care4704313471MICHIGANYes

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: 3/30/2025

NPI Synchronization or Removal

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