Individual
MAKEBA SIMONE WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
47610 GRAND RIVER AVE # 1211, NOVI, MI 48374-1217
(313) 633-5604
Mailing address
47610 GRAND RIVER AVE # 1211, NOVI, MI 48374-1217
(313) 633-5604
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704309839
MI
Other
Enumeration date
08/07/2024
Last updated
08/07/2024
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