Basic Information
| Provider Information | |||||||||
| NPI: | 1336226422 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OGLETREE | ||||||||
| FirstName: | NAIMA | ||||||||
| MiddleName: | LATRIESE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DNP, MSN, APRN, BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14955 TAYLOR BLVD | ||||||||
| Address2: | |||||||||
| City: | LIVONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481544065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7342662013 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2799 W GRAND BLVD # CFP-547 | ||||||||
| Address2: | |||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482022608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3139162702 | ||||||||
| FaxNumber: | 3139162554 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 01/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 4704208571 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.