RYAN HAVENS AGPCNP-BC
NPI 1629473228
Nurse Practitioner - Gerontology in Royal Oak, MI
Active since October 27, 2014
About Ryan Havens Agpcnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RYAN HAVENS AGPCNP-BC (NPI 1629473228) is an individual gerontology provider in Royal Oak, Michigan, licensed in Michigan (4704230300) and active in the NPI registry since October 2014. He maintains a secondary practice location in Troy.
NPPES Registry Identity
NPI1629473228
Entity TypeIndividualMale
Primary Taxonomy363LG0600X
Provider Legal NameRYAN HAVENSCredential: AGPCNP-BC
Location Address3601 W 13 MILE RDRoyal Oak, MI 48073-6712
Mailing Address26901 Beaumont Blvd Ste 3dSouthfield, MI 48033-3849
Phone(248) 898-4021
Fax(248) 898-1473
Sole ProprietorNo
Enumeration DateOctober 27, 2014
Last NPPES UpdateNovember 4, 2021
NPPES CertifiedNovember 4, 2021
✔ NPI 1629473228 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 3
★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in MI · 4704230300
Also ListedNurse PractitionerTaxonomy 363L00000X · License 4704230300 (MI)
Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License 4704230300 (MI)
3601 W 13 MILE RD, Royal Oak, MI 48073
Secondary Practice Location 1
Location 14600 Investment Dr, Suite 200Troy, MI 48098-6365 · Phone (248) 267-5050
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Pathology (Chemical Pathology)
3601 W 13 MILE RD, WILLIAM BEAUMONT HOSPITAL, DEPT. OF CLINICAL PATHOLOGY
ROYAL OAK, MI 48073
ROYAL OAK, MI 48073
Anesthesiology (Pain Medicine)
3601 W 13 MILE RD, ANESTHESIOLOGY DEPT
ROYAL OAK, MI 48073
ROYAL OAK, MI 48073
Medical Genetics, Ph.D. Medical Genetics
3601 W 13 MILE RD
ROYAL OAK, MI 48073
ROYAL OAK, MI 48073
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1629473228, enumerated as an "individual" on October 27, 2014.
The provider is located at 3601 W 13 MILE RD ROYAL OAK, MI 48073 and the phone number is (248) 898-4021.
Nurse Practitioner with taxonomy code 363LG0600X and a focus in Gerontology.
