Individual
TAYLOR WHITE-WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6821 MEDBURY ST, DETROIT, MI 48211-3317
(313) 922-2222
Mailing address
6821 MEDBURY ST, DETROIT, MI 48211-3317
(313) 922-2222
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703131365
MI
Other
Enumeration date
05/14/2026
Last updated
05/14/2026
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