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Individual

MRS. DEBORAH JANE COLLIER-BARSTAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S.N.

Contact information

Practice address
15255 NORTHLINE RD, SOUTHGATE, MI 48195-2487
(734) 285-3090
(734) 285-3095
Mailing address
15753 PROMENADE AVE, ALLEN PARK, MI 48101-1196

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704158669
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
296-0240
MI
01
50-0-86-6148-0
BCBSM PIN
MI
Enumeration date
01/31/2007
Last updated
07/09/2007
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