Individual
MS. GENEVIEVE FRANCES POMERVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
(313) 576-1264
Mailing address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
(313) 576-1264
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
4704251632
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2011016916
ANCC
MI
01
—
4704251632
MI STATE LICENSE
MI
Enumeration date
05/18/2012
Last updated
03/30/2017
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