Individual
HOLLY ANNE LIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1400 S SHELDON RD, PLYMOUTH, MI 48170-2140
(734) 453-5807
Mailing address
21110 WOODLAND GLEN DR APT 202, NORTHVILLE, MI 48167-2445
(734) 751-5158
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704187460
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704187460
NURSING LICENSE
MI
Enumeration date
12/24/2020
Last updated
12/24/2020
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