Individual
JARAH STAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
21832 EHLERT AVE, WARREN, MI 48089-2887
(313) 955-9338
Mailing address
21832 EHLERT AVE, WARREN, MI 48089-2887
(313) 955-9338
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704310119
MI
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
4704310119
MI
Other
Enumeration date
08/30/2022
Last updated
08/30/2022
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