Individual provider · Type 1 NPI
Emma Kristine Mandouh, NP
Nurse Practitioner · Warren, MI
Practice location
21230 Dequindre Rd
Warren, MI 48091-2279
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 4704362447 (MI) |
| Nurse Practitioner Primary | 363L00000X | 4704362447 (MI) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1285592162
Emma Kristine Mandouh, NP's National Provider Identifier is 1285592162, issued on Jan 12, 2026. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Warren, MI. The record was last updated on Jul 21, 2026.