Individual
MARY BERNADETTE WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
27175 HAGGERTY RD, NOVI, MI 48377-3626
(248) 799-8303
Mailing address
581 BLUE HERON DR, APT 308B, HALLANDALE BEACH, FL 33009-5738
(917) 853-2727
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9211314
FL
Other
Enumeration date
05/22/2013
Last updated
05/22/2013
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