Individual
MICHELLE JACQUELINE WILMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
400 RENAISSANCE CTR STE 2600, DETROIT, MI 48243-1502
(877) 702-6863
Mailing address
400 RENAISSANCE CTR STE 2600, DETROIT, MI 48243-1502
(877) 702-6863
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
4704321495
MI
363L00000X
Nurse Practitioner
Primary
4704321495
MI
Other
Enumeration date
04/25/2021
Last updated
11/26/2021
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