Individual
CHRISEANA HERNDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9445 MANISTIQUE ST, DETROIT, MI 48224-2864
(313) 348-6988
Mailing address
9445 MANISTIQUE ST, DETROIT, MI 48224-2864
(313) 348-6988
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703105966
MI
Other
Enumeration date
12/11/2014
Last updated
12/11/2014
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