Individual
JAMIKA MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16866 MENDOTA ST, DETROIT, MI 48221-2829
(313) 999-9999
Mailing address
16866 MENDOTA ST, DETROIT, MI 48221-2829
(313) 999-9999
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704285912
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704285912
LICENSE
MI
Enumeration date
12/06/2013
Last updated
12/06/2013
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