Individual
REBECCA LYNN MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
2263 CEDAR ST, HOLT, MI 48842-1202
(517) 694-2179
Mailing address
6300 TIMBERLAND DR, DIMONDALE, MI 48821-9755
(517) 980-9226
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704328507
MI
Other
Enumeration date
04/13/2021
Last updated
04/13/2021
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