Individual
BARBRENE LATRESE MAHLULI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, NP, ANP-BC
Contact information
Practice address
30395 STELLAMAR ST, BEVERLY HILLS, MI 48025-4930
(313) 673-8636
Mailing address
30395 STELLAMAR ST, BEVERLY HILLS, MI 48025-4930
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
4704251083
MI
363LP2300X
Primary Care Nurse Practitioner
4704251083
MI
Other
Enumeration date
03/03/2014
Last updated
11/28/2022
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