# JANNATUL FARDAWSY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1821674540
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 4704328478 | MI | Yes |
| 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