Individual
THEA Y PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
25900 GREENFIELD RD STE 414, OAK PARK, MI 48237-1267
(313) 268-0453
Mailing address
4132 9TH ST, ECORSE, MI 48229-1208
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
4704314750
MI
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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