Individual
MS. LAVETTA ANNETTE PICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
611 MARTIN LUTHER KING JR BLVD, DETROIT, MI 48201-2273
(313) 832-6300
Mailing address
10535 LANARK ST, DETROIT, MI 48224-1232
(313) 642-0478
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
4704221867
MI
Other
Enumeration date
01/18/2013
Last updated
01/18/2013
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