Provider Demographics
NPI:1154036978
Name:HAROON, SAMREEN (NP)
Entity type:Individual
Prefix:
First Name:SAMREEN
Middle Name:
Last Name:HAROON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3645 WEST RD
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-2225
Mailing Address - Country:US
Mailing Address - Phone:734-486-4200
Mailing Address - Fax:734-486-4202
Practice Address - Street 1:3645 WEST RD
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-2225
Practice Address - Country:US
Practice Address - Phone:734-486-4200
Practice Address - Fax:734-486-4202
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704317014363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily