Individual
CHANTELLE GOLOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPC-NP
Contact information
Practice address
4100 JOHN R ST, DETROIT, MI 48201-2013
(313) 576-8090
Mailing address
4100 JOHN R ST, DETROIT, MI 48201-2013
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704346114
MI
363LG0600X
Gerontology Nurse Practitioner
4704346114
MI
Other
Enumeration date
11/07/2022
Last updated
04/19/2025
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