Individual
MRS. CHANTELLE MORRISON-KOUROUMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11807 WILSHIRE DR, DETROIT, MI 48213-1618
(313) 469-9260
(313) 469-9260
Mailing address
13560 E MCNICHOLS RD, DETROIT, MI 48205-3426
(313) 469-9260
(313) 469-9260
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704258152
MI
163WS0200X
School Registered Nurse
4704258152
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77
—
MI
Enumeration date
10/30/2009
Last updated
05/19/2010
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