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Individual
JANNATUL FARDAWSY
Active
Individual
JANNATUL FARDAWSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704328478
MI
363L00000X
Nurse Practitioner
F12200115
MI
363LF0000X
Family Nurse Practitioner
4704328478
MI
363LF0000X
Family Nurse Practitioner
F12200115
MI
363LP2300X
Primary Care Nurse Practitioner
F12200115
MI
Other
Enumeration date
03/23/2021
Last updated
08/13/2021
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