Provider Demographics
NPI:1902349160
Name:SENIOR HEALTH PARTNER
Entity Type:Organization
Organization Name:SENIOR HEALTH PARTNER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VERA
Authorized Official - Middle Name:
Authorized Official - Last Name:JABER
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:313-384-3069
Mailing Address - Street 1:PO BOX 7060
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48121-7060
Mailing Address - Country:US
Mailing Address - Phone:313-355-9800
Mailing Address - Fax:313-557-0144
Practice Address - Street 1:10140 VERNOR HWY
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48120-1515
Practice Address - Country:US
Practice Address - Phone:313-413-8684
Practice Address - Fax:888-242-0942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704267744363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty