Individual
MICHELLE CAROLINE POBEREZNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2333 BIDDLE ST, WYANDOTTE, MI 48192-4668
(734) 246-6000
Mailing address
2333 BIDDLE ST, WYANDOTTE, MI 48192-4668
(734) 246-6000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704197675
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704197675
LICENSE
MI
01
—
9420589
CANADIAN LICENSE
—
Enumeration date
07/19/2006
Last updated
07/08/2007
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