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Individual

LANE BERNICE JUDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
15506 S TELEGRAPH RD, MONROE, MI 48161-5520
(734) 682-5243
Mailing address
4057 CHERYL DR, COMMERCE TWP, MI 48382-1759
(248) 660-4981

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704316371
MI

Other

Enumeration date
09/11/2017
Last updated
09/11/2017
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