Individual
ANGEL HAIRSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3990 JOHN R ST, DETROIT, MI 48201-2018
(313) 745-8040
Mailing address
15393 ASHURST ST, LIVONIA, MI 48154-2603
(313) 300-8776
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704298503
MI
Other
Enumeration date
03/15/2022
Last updated
03/15/2022
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