Individual
CHARLENE WALTON WINDHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17515 W 9 MILE RD, 375, SOUTHFIELD, MI 48075-4403
(248) 559-0950
Mailing address
17515 W 9 MILE RD, STE. 375, SOUTHFIELD, MI 48075-4403
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
4704210421
MI
Other
Enumeration date
09/15/2015
Last updated
09/15/2015
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