Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Fairy Queen Enriquez Siekierka, AGACNP-BC

Individual provider Nurse Practitioner · NPI 1932985322

Fairy Queen Enriquez Siekierka, AGACNP-BC is a Nurse Practitioner in Detroit, Michigan. Qualified in 2023, 3 years ago. Practices with Promed Preferred Mi 2 PLLC, an 8-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
3
Licensed in
MI
In the registry since
2023
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Practice location Address checks out

3990 John R St
Detroit, MI 48201-2018
Phone: (313) 745-5111
Fax: (313) 745-3500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 4704328579 (MI)

Record details

NPI number1932985322
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP-BC
Sole proprietorYes
NPI enumeratedSeptember 1, 2023
Last updated in NPPESNovember 6, 2024
Certification dateNovember 6, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Promed Preferred Mi 2 Pllc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Detroit