Individual
KATRINA IVORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
11000 W MCNICHOLS RD STE 3231029, DETROIT, MI 48221-2357
(313) 649-5188
Mailing address
11000 W MCNICHOLS RD STE 3231029, DETROIT, MI 48221-2357
(313) 649-5188
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
0041323
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704377051
MI
Other
Enumeration date
01/30/2026
Last updated
03/11/2026
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