Individual
MADISON CATHERINE CHAMPNELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21260 KNUDSEN DR, GROSSE ILE, MI 48138-1100
(734) 776-4269
Mailing address
21260 KNUDSEN DR, GROSSE ILE, MI 48138-1100
(734) 776-4269
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704330790
MI
Other
Enumeration date
07/24/2024
Last updated
07/24/2024
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