Provider Demographics
NPI:1063915312
Name:MIRACLE CARING HANDS OF MICHIGAN LLC
Entity type:Organization
Organization Name:MIRACLE CARING HANDS OF MICHIGAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DNP
Authorized Official - Prefix:DR
Authorized Official - First Name:TORITSETSE
Authorized Official - Middle Name:CYNTHIA
Authorized Official - Last Name:ANIEJURENGHO
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:734-775-2105
Mailing Address - Street 1:23219 DEMICK CT
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN
Mailing Address - State:MI
Mailing Address - Zip Code:48134-6019
Mailing Address - Country:US
Mailing Address - Phone:734-775-2105
Mailing Address - Fax:
Practice Address - Street 1:23219 DEMICK CT
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN
Practice Address - State:MI
Practice Address - Zip Code:48134-6019
Practice Address - Country:US
Practice Address - Phone:734-775-2105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704263570363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty