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Organization
ELAN VITALE HEALTHY LIVING SOLUTIONS
Active
Organization
ELAN VITALE HEALTHY LIVING SOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE DUNCAN PMHNP (NURSE PRACTITIONER)
(248) 667-2531
Entity
Organization
Contact information
Practice address
27247 JOY RD, DEARBORN HTS, MI 48127-1022
(248) 667-6307
Mailing address
27247 JOY RD, DEARBORN HTS, MI 48127-1022
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704170920
MI
Other
Enumeration date
03/14/2018
Last updated
03/14/2018
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