Individual
MRS. MONICA AMENA BRAXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3737 LAWTON ST, DETROIT, MI 48208-2500
(313) 361-6136
(313) 361-6210
Mailing address
14620 WESTWOOD ST, DETROIT, MI 48223-2298
(313) 949-9914
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703109635
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4703109635
—
MI
Enumeration date
02/16/2022
Last updated
02/16/2022
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