Individual
MS. KEISHA TAMARA LOVENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
15101 W MCNICHOLS RD, DETROIT, MI 48235-3716
(313) 838-4600
Mailing address
630 MERRICK ST, DETROIT, MI 48202-3950
(313) 854-8838
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
4704264763
MI
Other
Enumeration date
02/05/2013
Last updated
02/05/2013
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