Individual
GWENDOLYN PHINISEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1102 MACKIN RD, FLINT, MI 48503-1204
(810) 257-3676
(810) 257-0713
Mailing address
1102 MACKIN RD, FLINT, MI 48503-1204
(810) 257-3676
(810) 257-0713
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
4704145655
MI
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
4704145655
MI
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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