Individual
MRS. MARY KAY BRODRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
48190 W 10 MILE RD, NOVI, MI 48374-2813
(313) 590-5835
(708) 910-3138
Mailing address
48190 W 10 MILE RD, NOVI, MI 48374-2813
(313) 590-5835
(708) 910-3138
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
4704238653
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704238653
NURSING LICENSE
MI
Enumeration date
08/05/2021
Last updated
08/05/2021
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