1780154765 NPI number — MRS. BIANCA CHRISTINA ZUELLIG AGPCNP

Table of content: MRS. BIANCA CHRISTINA ZUELLIG AGPCNP (NPI 1780154765)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780154765 NPI number — MRS. BIANCA CHRISTINA ZUELLIG AGPCNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZUELLIG
Provider First Name:
BIANCA
Provider Middle Name:
CHRISTINA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
AGPCNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CAPORUSCIO
Provider Other First Name:
BIANCA
Provider Other Middle Name:
CHRISTINA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1780154765
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/13/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
28595 ORCHARD LAKE RD STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARMINGTON HILLS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48334-2979
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-553-0010
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
28595 ORCHARD LAKE RD STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FARMINGTON HILLS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48334-2979
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-445-9900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/03/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  4704297450 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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