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Individual

MS. ELLEN WONG DILLARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
4100 JOHN R ST, DETROIT, MI 48201-2013
(313) 576-9096
(313) 576-8422
Mailing address
4100 JOHN R ST, DETROIT, MI 48201-2013
(313) 576-9096
(313) 576-8422

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704288766
MI

Other

Enumeration date
07/30/2019
Last updated
07/30/2019
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