Individual
LUCRETIA ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
215 COLORADO ST, HIGHLAND PARK, MI 48203-3305
(313) 414-4583
Mailing address
215 COLORADO ST, HIGHLAND PARK, MI 48203-3305
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703105961
MI
Other
Enumeration date
11/21/2025
Last updated
11/21/2025
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