MS. MELISSA SUSAN BOOTHROYD PNP NPI 1649356551

NPI Information

NPI: 1649356551
Provider Name: MS. MELISSA SUSAN BOOTHROYD, PNP
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

Address:
23200 RYAN RD
FITZGERALD HEALTH CENTER
WARREN, MI
ZIP 48091
Phone: (586) 759-9070
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MS. Melissa Susan Boothroyd, PNP is a pediatrics nurse practitioner in Warren, MI. MS. Melissa Susan Boothroyd, PNP NPI is 1649356551. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

23200 RYAN RD
FITZGERALD HEALTH CENTER
WARREN, MI
ZIP 48091-551
Phone: (586) 759-9070

The enumeration date for this NPI number is 10/31/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0200X	Nurse Practitioner	Pediatrics	4704121618	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	4667898	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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