Individual
MRS. DENISE WILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
221 S MAIN ST, SUITE 100, ROYAL OAK, MI 48067-2611
(248) 545-9200
Mailing address
557 BOUTELL DR, GRAND BLANC, MI 48439-1533
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
4704203414
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704203414
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4624040
—
MI
Enumeration date
06/15/2006
Last updated
09/09/2007
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