# QUEEN OF HEARTS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174094627
- **Authorized official:** MISS NICHOLE DEGREE LPN (LPN/OWNER)
- **Authorized official phone:** (414) 630-0379

## Contact information

- **Practice address:** 1431 WASHINGTON BLVD APT 2306, DETROIT, MI 48226-1728
- **Practice address phone:** (414) 630-0379
- **Mailing address:** 1431 WASHINGTON BLVD APT 2306, DETROIT, MI 48226-1728
- **Mailing address phone:** (414) 630-0379

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 164W00000X | Licensed Practical Nurse | — | NULL | Yes |
| 164W00000X | Licensed Practical Nurse | — | — | Yes |

## Other

- **Enumeration date:** 12/10/2018
- **Last updated:** 06/11/2019