Individual
MRS. AKA PRODENTIA NKEMATABONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
20436 NORTHLAWN ST, DETROIT, MI 48221-1156
(313) 402-6348
Mailing address
20436 NORTHLAWN ST, DETROIT, MI 48221-1156
(313) 402-6348
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704280238
MI
163WH0200X
Home Health Registered Nurse
4704280238
MI
372600000X
Adult Companion
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—
Other
Enumeration date
03/05/2024
Last updated
03/05/2024
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