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

Gerald Angelo Ciccotelli Jr., RN

Individual provider General Practice Registered Nurse · NPI 1689388282

Gerald Angelo Ciccotelli Jr., RN is a General Practice Registered Nurse in Detroit, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2023
Specialties on file
2
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

4646 John R St
Detroit, MI 48201-1916
Phone: (313) 576-1000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Registered Nurse (primary) Taxonomy 163WG0000X · Licence 4704187346 (MI)
Emergency Registered Nurse Taxonomy 163WE0003X · Licence 4704187346 (MI)

Record details

NPI number1689388282
Entity typeIndividual (Type 1)
GenderMale
Credentials RN
Sole proprietorYes
NPI enumeratedJanuary 9, 2023
Last updated in NPPESJanuary 9, 2023
Certification dateJanuary 9, 2023
Mailing address4646 John R St, Detroit, MI 48201-1916

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