Individual
LAUREN ELISSA TABOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P., R.N.
Contact information
Practice address
4569 NORTHRIDGE CT, WEST BLOOMFIELD, MI 48323-1397
(586) 204-6686
(248) 850-7142
Mailing address
27901 WOODWARD AVE, SUITE 220, BERKLEY, MI 48072-0919
(248) 556-5582
(248) 850-7142
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704259700
MI
363LA2200X
Adult Health Nurse Practitioner
Primary
4704259700
MI
Other
Enumeration date
12/08/2011
Last updated
09/05/2024
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