Individual
MISS BEVERLY ANN GAYLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
13929 HARPER AVE, DETROIT, MI 48213-3672
(313) 371-0055
Mailing address
11404 WARREN BLVD APT 102, WARREN, MI 48089-1044
(313) 740-1390
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703083426
MI
Other
Enumeration date
11/08/2010
Last updated
11/08/2010
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