Individual
MRS. D'ANN A FAULKS-BLOUNT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
15000 GRATIOT AVE, DETROIT, MI 48205-1973
(313) 245-0600
Mailing address
11435 CHRISTY ST, DETROIT, MI 48205-3750
(313) 371-1322
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703054384
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4703054384
LICENSED PRACTICAL NURSE
MI
Enumeration date
02/01/2007
Last updated
07/08/2007
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