Individual
JENNIFER M GIDEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1560 E MAPLE RD, SUITE 400 - CREDENTIALING, TROY, MI 48083-1138
(313) 745-4525
(313) 745-0011
Mailing address
4160 JOHN R ST, STE 917, DETROIT, MI 48201-2020
(313) 745-4525
(313) 745-0011
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704139802
MI
Other
Enumeration date
05/09/2016
Last updated
06/28/2016
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