Individual
MRS. MARY CATHERINE DELUCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
15675 NORTHLINE RD, SOUTHGATE, MI 48195-2334
(734) 282-3600
(734) 282-3603
Mailing address
1640 FORT ST, SUITE D ATTN: DENISE, TRENTON, MI 48183-2040
(734) 391-3057
(734) 391-3052
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
4704127749
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H28865
BLUE CROSS
MI
01
—
1144634403
GROUP NPI HENRY FORD WYANDOTTE
—
Enumeration date
01/06/2006
Last updated
02/21/2017
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