Provider Demographics
NPI:1215614268
Name:JAMIL, RIAM LUCY (FNP-C)
Entity type:Individual
Prefix:MS
First Name:RIAM
Middle Name:LUCY
Last Name:JAMIL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:RIAM
Other - Middle Name:LUCY
Other - Last Name:KISTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR
Mailing Address - Street 2:SUITE J2000
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:
Practice Address - Street 1:IHA HEMATOLOGY ONCOLOGY
Practice Address - Street 2:44405 WOODWARD AVE SUITE 202
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341
Practice Address - Country:US
Practice Address - Phone:248-858-2270
Practice Address - Fax:248-335-6171
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIF06231513363LF0000X
MI4704329537363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily