Individual provider · Type 1 NPI

Maryam Blackeagle

Licensed Practical Nurse · Dearborn Heights, MI

NPI number 1104285881 Active

Practice location

8445 Norborne Ave
Dearborn Heights, MI 48127-1125

Call (734) 727-3010 Map

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X4703085481 (MI)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1104285881

Maryam Blackeagle's National Provider Identifier is 1104285881, issued on Feb 23, 2016. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Dearborn Heights, MI. The record was last updated on Feb 23, 2016.