Individual
MS. SHATERIA MICHELLE BOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6309 MACK AVE, DETROIT, MI 48207-2302
(888) 813-8326
Mailing address
6309 MACK AVE, DETROIT, MI 48207-2302
(313) 921-4700
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704229347
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704229347
MI
Other
Enumeration date
04/03/2024
Last updated
04/14/2026
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