Individual
EDITH AMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
10 PETERBORO ST, DETROIT, MI 48201-2722
(313) 578-6123
(313) 309-1090
Mailing address
10 PETERBORO ST, DETROIT, MI 48201-2722
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F11180802
MI
Other
Enumeration date
01/20/2019
Last updated
06/10/2024
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