Individual
MARQUITA OUTLAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
8290 COYLE ST, DETROIT, MI 48228
(313) 510-8545
Mailing address
3319 GREENFIELD RD # 145, DEARBORN, MI 48120-1212
(313) 638-0038
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704220007
MI
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
06/13/2018
Last updated
07/14/2018
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