Individual
MS. CHAUNTEL HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
62 W 7 MILE RD, DETROIT, MI 48203-1967
(313) 893-0064
Mailing address
62 W 7 MILE RD, DETROIT, MI 48203-1967
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704261321
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3434247
—
MI
Enumeration date
04/17/2017
Last updated
04/17/2017
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