Individual
JENELL ANGEL FACHOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
44201 DEQUINDRE RD, TROY, MI 48085-1117
(248) 964-5000
Mailing address
46165 DEQUINDRE RD, ROCHESTER HILLS, MI 48307-4875
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704307181
MI
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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