Basic Information
| Provider Information | |||||||||
| NPI: | 1801076328 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOSLER | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | BROOKE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | APRN, BC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | KEETON | ||||||||
| OtherFirstName: | EMILY | ||||||||
| OtherMiddleName: | BROOKE | ||||||||
| OtherNamePrefix: | MISS | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | FNP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 26400 W 12 MILE RD | ||||||||
| Address2: | SUITE 170 | ||||||||
| City: | SOUTHFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480341700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2482088787 | ||||||||
| FaxNumber: | 2482088788 | ||||||||
| Practice Location | |||||||||
| Address1: | 26400 W. 12 MILE ROAD | ||||||||
| Address2: | SUITE 170 | ||||||||
| City: | SOUTHFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480341753 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2482088787 | ||||||||
| FaxNumber: | 2482088788 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2007 | ||||||||
| LastUpdateDate: | 02/29/2016 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 4704244707 | MI | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LA2200X | 4704244707 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.