Individual
JOHN L NIGHTINGALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-4328
Mailing address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-4328
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703116374
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4703116374
LICENSED PRACTICAL NURSE
MI
Enumeration date
10/18/2022
Last updated
10/18/2022
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