Individual provider · Type 1 NPI

Tracy Bosanko, PMHNP

Adult Psychiatric/Mental Health Registered Nurse · Livonia, MI

NPI number 1184445264 Active

Practice location

17177 N Laurel Park Dr Ste 131
Livonia, MI 48152-3952

Fax (734) 462-1024

Mailing address

5842 Hathaway Rd
Canton, MI 48187-5609

Other practice locations

  • 5842 Hathaway Rd, Canton, MI 48187-5609 · (734) 536-3043

Specialties and licenses

TaxonomyCodeLicense
Adult Psychiatric/Mental Health Registered Nurse Primary 163WP0809X4704329968 (MI)

Adult Psychiatric/Mental Health Registered Nurse: Definition to come...

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About NPI 1184445264

Tracy Bosanko, PMHNP's National Provider Identifier is 1184445264, issued on Oct 21, 2024. The primary taxonomy on file is Adult Psychiatric/Mental Health Registered Nurse (163WP0809X), and the practice location is in Livonia, MI. The record was last updated on Jun 6, 2025.