Individual
MS. VICKI MARIE IRISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP(WOMEN'S HEALTH)
Contact information
Practice address
2799 W GRAND BLVD, K-9 UROLOGY, DETROIT, MI 48202-2608
(313) 916-2062
(313) 916-8869
Mailing address
2799 W GRAND BLVD, K-9 UROLOGY, DETROIT, MI 48202-2608
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
0024168785
VA
363LW0102X
Women's Health Nurse Practitioner
Primary
4704208777
MI
Other
Enumeration date
10/04/2005
Last updated
03/30/2021
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