Individual
MARY FAVATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1101 W UNIVERSITY DR, ROCHESTER, MI 48307-1863
(248) 652-5813
Mailing address
1101 W UNIVERSITY DR, ROCHESTER, MI 48307-1863
(248) 652-5813
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704126972
MI
Other
Enumeration date
10/15/2008
Last updated
10/15/2008
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