Provider Demographics
NPI:1447391461
Name:HOES, MARY LINDA (PHD, APRN-C, NP)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:LINDA
Last Name:HOES
Suffix:
Gender:F
Credentials:PHD, APRN-C, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7456 GLENGROVE DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301-3870
Mailing Address - Country:US
Mailing Address - Phone:248-626-0373
Mailing Address - Fax:248-540-4937
Practice Address - Street 1:30400 TELEGRAPH RD
Practice Address - Street 2:SUITE 324
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4537
Practice Address - Country:US
Practice Address - Phone:248-540-4800
Practice Address - Fax:248-540-4937
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704147997363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0865502OtherBLUE CROSS-BLUE SHIELD
MI0865502OtherBLUE CROSS-BLUE SHIELD