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Individual

EMMA KRISTINE MANDOUH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
21230 DEQUINDRE RD, WARREN, MI 48091-2279
(586) 427-1000
Mailing address
21230 DEQUINDRE RD, WARREN, MI 48091-2279

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704362447
MI
163WG0000X
General Practice Registered Nurse
Primary
4704362447
MI
363L00000X
Nurse Practitioner
Primary
4704362447
MI

Other

Enumeration date
01/12/2026
Last updated
07/21/2026
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