Organization
JOHN D. DINGELL VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA ANTOINETTE HICKS LPN (TELEHEALTH COORDINATOR)
(313) 576-1000
Entity
Organization
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Mailing address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
—
—
Other
Enumeration date
01/09/2023
Last updated
01/09/2023
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