Individual
JOLA JANAQI FORTHOFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-4370
Mailing address
130 TOWN CENTER DR, STE 203, TROY, MI 48084-1744
(248) 585-8216
(248) 585-8266
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704267187
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704267187
MI
Other
Enumeration date
12/11/2012
Last updated
10/27/2016
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