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Individual

JESSICA R MANDZIARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
466 PEARSON ST, FERNDALE, MI 48220-3308
(734) 752-3476
Mailing address
466 PEARSON ST, FERNDALE, MI 48220-3308
(734) 752-3476

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704321864
MI
363L00000X
Nurse Practitioner
72242
ID

Other

Enumeration date
12/09/2021
Last updated
07/24/2025
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