Individual
JORDAN ALEXANDRIA JUDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5450 FORT ST, TRENTON, MI 48183-4601
(734) 671-3800
Mailing address
30411 WESTFIELD ST, LIVONIA, MI 48150-3961
(734) 558-0490
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704272562
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
123350
MI
Other
Enumeration date
08/02/2019
Last updated
10/09/2019
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