Provider Demographics
NPI:1063520211
Name:MAFEE, MAHNAZ S (NP-C)
Entity type:Individual
Prefix:MRS
First Name:MAHNAZ
Middle Name:S
Last Name:MAFEE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44429 HARMONY LN
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48111-2409
Mailing Address - Country:US
Mailing Address - Phone:734-697-7431
Mailing Address - Fax:
Practice Address - Street 1:33330 PALMER RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-5529
Practice Address - Country:US
Practice Address - Phone:734-729-3080
Practice Address - Fax:734-729-9435
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704184387363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health