Individual
DONNA JEAN CARRICO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3601 W 13 MILE RD - FSC, ROYAL OAK, MI 48073-6712
(248) 423-2454
Mailing address
3601 W 13 MILE RD - FSC, ROYAL OAK, MI 48073-6712
(248) 423-2454
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
4704122237
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F31819
BCBS
MI
05
—
4673438
—
MI
Enumeration date
06/15/2006
Last updated
07/08/2007
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