Individual
PAMELA DENISE HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8623 N WAYNE RD, WESTLAND, MI 48185-1137
(734) 458-4601
Mailing address
14139 GARFIELD, REDFORD, MI 48239-2834
(313) 475-1424
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703064713
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4703064713
—
MI
Enumeration date
09/22/2022
Last updated
09/22/2022
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