Individual
LEANNE GRACE VANGILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 874-6256
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704326425
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704326425
MI
Other
Enumeration date
07/09/2021
Last updated
01/27/2026
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