Individual
JUANITA G DEFAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BAS
Contact information
Practice address
4000 PORTAGE ST STE 113, KALAMAZOO, MI 49001-4962
(269) 759-4823
Mailing address
110 S BENTON CENTER RD, BENTON HARBOR, MI 49022-9782
(269) 759-4823
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704191219
MI
Other
Enumeration date
08/10/2021
Last updated
12/28/2021
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