Provider Demographics
NPI:1538441928
Name:ZEGREAN, MIHAELA (ACNP-BC)
Entity type:Individual
Prefix:
First Name:MIHAELA
Middle Name:
Last Name:ZEGREAN
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5565 WALKER RD
Mailing Address - Street 2:
Mailing Address - City:OLDCASTLE
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:N0R1L0
Mailing Address - Country:CA
Mailing Address - Phone:1519-991-6381
Mailing Address - Fax:
Practice Address - Street 1:4160 JOHN R ST
Practice Address - Street 2:525
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2020
Practice Address - Country:US
Practice Address - Phone:313-831-1100
Practice Address - Fax:313-831-1177
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704247769363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care