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Individual
MRS. MONICA AMENA BRAXTON
Active
Individual
MRS. MONICA AMENA BRAXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703109635
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4703109635
—
MI
Enumeration date
02/16/2022
Last updated
02/16/2022
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