Individual
GRACE ANNE JACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2845 BURNS ST, DEARBORN, MI 48124-3261
(313) 283-5034
Mailing address
2845 BURNS ST, DEARBORN, MI 48124-3261
(313) 283-5034
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704191011
MI
Other
Enumeration date
12/29/2009
Last updated
12/29/2009
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