Individual
VANESSA MISUKANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2600
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
4704278565
MI
363LG0600X
Gerontology Nurse Practitioner
Primary
4704278565
MI
Other
Enumeration date
03/18/2017
Last updated
05/09/2017
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