Individual
JILL MARIE CISZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
27278 RONEY AVE, BROWNSTOWN TWP, MI 48183-4849
(734) 552-6526
Mailing address
27278 RONEY AVE, BROWNSTOWN TWP, MI 48183-4849
(734) 552-6526
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704170540
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4704170540
—
MI
Enumeration date
08/08/2017
Last updated
02/16/2021
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