Provider Demographics
NPI:1841504438
Name:ABRAHAM, MARY KAY (NP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:KAY
Last Name:ABRAHAM
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Gender:F
Credentials:NP
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Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DRIVE
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:734-222-3100
Practice Address - Street 1:5333 MCAULEY DRIVE
Practice Address - Street 2:SUITE 3001
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197
Practice Address - Country:US
Practice Address - Phone:734-712-8100
Practice Address - Fax:734-887-8942
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-06
Last Update Date:2024-11-06
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Provider Licenses
StateLicense IDTaxonomies
MI4704221666363A00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care