Individual
MARY TARGOSZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2561 ELIZABETH LAKE RD, WATERFORD, MI 48328-3313
(248) 682-3300
(248) 682-0026
Mailing address
2561 ELIZABETH LAKE RD, WATERFORD, MI 48328-3313
(248) 682-3300
(248) 682-0026
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704128135
MI
Other
Enumeration date
03/29/2007
Last updated
07/03/2012
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