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SOPHONIE EDGLA PHILIDOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2900 COLLINS RD, LANSING, MI 48910-8394
(517) 975-6000
Mailing address
1607 SNYDER RD, EAST LANSING, MI 48823-3747
(517) 862-6838

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704324784
MI
363L00000X
Nurse Practitioner
Primary
4704324784
MI

Other

Enumeration date
04/14/2023
Last updated
05/16/2024
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