Provider Demographics
NPI:1861177024
Name:SPASENOVSKA, TATJANA
Entity type:Individual
Prefix:
First Name:TATJANA
Middle Name:
Last Name:SPASENOVSKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49212 GRACECHURCH RD
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-1528
Mailing Address - Country:US
Mailing Address - Phone:586-504-4446
Mailing Address - Fax:586-991-5954
Practice Address - Street 1:49212 GRACECHURCH RD
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-1528
Practice Address - Country:US
Practice Address - Phone:586-504-4446
Practice Address - Fax:586-991-5954
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide