Individual
MRS. JOANNA PENNYWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2181 SHERATON DR, TRENTON, MI 48183-1944
(313) 401-6739
Mailing address
24635 ETON AVE, DEARBORN HEIGHTS, MI 48125-1807
(313) 401-6739
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704248741
MI
Other
Enumeration date
05/01/2017
Last updated
10/29/2019
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