| Residential Palliative Care | |
|
5440 Corporate Dr Suite 400 Troy MI 48098-2646 | |
| (866) 902-5854 | |
| (866) 903-4000 |
| Full Name | Residential Palliative Care |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 5440 Corporate Dr, Troy, Michigan |
| Authorized Official Name and Position | Justin Dewitte (PRESIDENT) |
| Authorized Official Contact | 2482838839 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Residential Palliative Care 5440 Corporate Dr Suite 400 Troy MI 48098-2646 Ph: (866) 902-5854 | Residential Palliative Care 5440 Corporate Dr Suite 400 Troy MI 48098-2646 Ph: (866) 902-5854 |
| NPI Number | 1750836664 |
|---|---|
| Provider Enumeration Date | 08/20/2016 |
| Last Update Date | 02/26/2019 |
| Medicare PECOS PAC ID | 0840333589 |
|---|---|
| Medicare Enrollment ID | O20161025000472 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750836664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 363LA2200X | Nurse Practitioner - Adult Health | (* (Not Available)) | Primary |
| Provider Name | Kathleen M Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568446383 PECOS PAC ID: 6507809373 Enrollment ID: I20050603000089 |
| Provider Name | Melissa A Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003369307 PECOS PAC ID: 5193003218 Enrollment ID: I20161025000841 |
| Provider Name | Dayna Buiting |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992247779 PECOS PAC ID: 6507146768 Enrollment ID: I20161205000641 |
| Provider Name | Kimberly Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942754213 PECOS PAC ID: 0345526034 Enrollment ID: I20170412000720 |
| Provider Name | Aubrey M Mcintosh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649752312 PECOS PAC ID: 2163757808 Enrollment ID: I20190717001811 |
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