Individual
NICOLE LYNN DESBROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704244076
MI
363LA2200X
Adult Health Nurse Practitioner
Primary
10043801
OR
363LA2200X
Adult Health Nurse Practitioner
4704244076
MI
Other
Enumeration date
12/28/2010
Last updated
09/08/2025
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