Individual
MISS ANGELA SELENA BRANTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
26705 W CARNEGIE PARK DR, SOUTHFIELD, MI 48034-6164
(313) 648-2259
Mailing address
26705 W CARNEGIE PARK DR, SOUTHFIELD, MI 48034-6164
(313) 648-2259
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703111095
MI
Other
Enumeration date
05/02/2014
Last updated
05/02/2014
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