Individual
MARY K HEDGLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
402 POTTER AVE, ANN ARBOR, MI 48103-5541
(734) 276-8511
Mailing address
2580 SOUTH INDUSTRIAL HWY, SUITE 75, ANN ARBOR, MI 48104
(734) 477-7298
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703031943
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4703031943
LPN STATE LICENSE
MI
Enumeration date
10/29/2009
Last updated
10/29/2009
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