Individual
STACEY TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4201 SAINT ANTOINE ST STE 5C, DETROIT, MI 48201-2153
(313) 745-7999
(313) 966-6400
Mailing address
1560 E MAPLE ROAD, SUITE 400 - CREDENTIALING, TROY, MI 48083-1138
(313) 745-7999
(313) 966-6400
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704246188
MI
Other
Enumeration date
06/01/2016
Last updated
10/29/2021
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