Individual
MARTHA MUKWADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C/PMHNP
Contact information
Practice address
220 W CONGRESS ST, DETROIT, MI 48226-3289
(269) 267-9763
Mailing address
5657 SPRINGRIDGE ST, PORTAGE, MI 49024-1271
(692) 677-9763
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
19133140548
MI
363LF0000X
Family Nurse Practitioner
4704259350
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704259350
MI
Other
Enumeration date
06/04/2019
Last updated
11/19/2024
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