Individual
SHELLY LAUREN BOUIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
308 CHALMERS ST, DETROIT, MI 48215-3162
(313) 409-5006
Mailing address
308 CHALMERS ST, DETROIT, MI 48215-3162
(313) 409-5006
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704241563
MI
Other
Enumeration date
12/26/2014
Last updated
12/26/2014
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