Individual
MRS. SCHAWANA THAXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11260 E JEFFERSON AVE, DETROIT, MI 48214-3320
(313) 749-0148
(313) 263-3298
Mailing address
PO BOX 746723, ATLANTA, GA 30374-6723
(312) 733-9730
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704221417
MI
Other
Enumeration date
10/19/2006
Last updated
06/21/2021
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