MARYAM BLACKEAGLE
NPI 1104285881
Licensed Practical Nurse in Dearborn Heights, MI

Q: What is Maryam Blackeagle's NPI number?

The NPI number for Maryam Blackeagle is 1104285881. It was assigned to this individual provider in the NPPES registry on February 23, 2016.

Q: What is Maryam Blackeagle's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

Q: When was this NPI record last updated?

The NPPES record for Maryam Blackeagle was last updated on February 23, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 23, 2016

8445 NORBORNE AVE, DEARBORN HEIGHTS, MI 48127(734) 727-3010 Get Directions Write a Review

NPPES record last updated: February 23, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Maryam Blackeagle NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARYAM BLACKEAGLE (NPI 1104285881) is an individual licensed practical nurse in Dearborn Heights, Michigan, licensed in Michigan (4703085481) and active in the NPI registry since February 2016.

NPPES Registry Identity

NPI1104285881

Entity TypeIndividualFemale

Primary Taxonomy164W00000X

Provider Legal NameMARYAM BLACKEAGLE

Location Address8445 NORBORNE AVEDearborn Heights, MI 48127-1125

Mailing Address8445 Norborne AveDearborn Heights, MI 48127-1125 · (734) 727-3010

Phone(734) 727-3010

Sole ProprietorNo

Enumeration DateFebruary 23, 2016

✔ NPI 1104285881 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers

Taxonomy Code164W00000X

License✔ Licensed in MI · 4703085481

Definition

A licensed practical nurse 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.

8445 NORBORNE AVE, Dearborn Heights, MI 48127

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Maryam Blackeagle's NPI number?

The NPI number for Maryam Blackeagle is 1104285881. It was assigned to this individual provider in the NPPES registry on February 23, 2016.

Where is Maryam Blackeagle located?

Maryam Blackeagle practices at 8445 Norborne Ave, Dearborn Heights, MI 48127. The listed phone number is (734) 727-3010.

What is Maryam Blackeagle's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Maryam Blackeagle was last updated on February 23, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.