Individual
MRS. LYNNYELL BRANDI WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
500 TOBIN DR APT 13, INKSTER, MI 48141-3530
(313) 502-7373
Mailing address
500 TOBIN DR APT 13, INKSTER, MI 48141-3530
(313) 502-7373
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703119354
MI
Other
Enumeration date
02/02/2019
Last updated
02/02/2019
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