Individual
STEPHANIE BICCUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2215 FULLER RD, ANN ARBOR, MI 48105-2303
(517) 764-3609
Mailing address
2215 FULLER RD, ANN ARBOR, MI 48105-2303
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
076643
GA
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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