Individual
MRS. MIRA EDGERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
4397 STONEYCROFT DR, OKEMOS, MI 48864-2935
(517) 349-0737
Mailing address
4397 STONEYCROFT DR, OKEMOS, MI 48864-2935
(517) 349-0737
Taxonomy
Speciality
Code
Description
License number
State
364SF0001X
Family Health Clinical Nurse Specialist
Primary
4704092938
MI
Other
Enumeration date
04/17/2009
Last updated
01/21/2014
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