Individual
MRS. JENNIFFER MARIE EFAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
615 N STATE ST STE 1, STANTON, MI 48888-9702
(989) 831-5237
(989) 831-3666
Mailing address
615 N STATE ST, SUITE 2, STANTON, MI 48888-9702
(989) 831-5237
(989) 831-5522
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4704187185
MI
2083P0901X
Public Health & General Preventive Medicine Physician
4704187185
MI
363L00000X
Nurse Practitioner
Primary
4704187185
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704187185
LICENSE - NURSE PRACTITIONER
MI
Enumeration date
10/29/2010
Last updated
05/25/2021
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