Individual
NICOLETTE OZOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18101 OAKWOOD BLVD, DEARBORN, MI 48124-4089
(313) 593-7465
Mailing address
39580 WILLOW RD, NEW BOSTON, MI 48164-9680
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704204145
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5893
BCBS
—
Enumeration date
09/02/2019
Last updated
09/02/2019
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