Maryam Blackeagle
NPI 1104285881ActiveIndividual· Licensed Practical Nurse· Dearborn Heights, MI
Licensed Practical Nurse in Dearborn Heights, Michigan, licensed in MI, with an NPI issued in February 2016.
Overview
| NPI | 1104285881 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Feb 23, 2016 |
| Last updated in NPPES | Feb 23, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Licensed Practical Nurse Primary | 164W00000X | 4703085481 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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