Individual
MEAGAN MARY DEANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1311 WINSTON DR, JACKSON, MI 49203-5026
(517) 416-0285
Mailing address
1311 WINSTON DR, JACKSON, MI 49203-5026
(517) 416-0285
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703097019
MI
Other
Enumeration date
03/27/2020
Last updated
03/27/2020
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