Individual
SHALETHA WEBSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
45300 CHERRY HILL RD, CANTON, MI 48187-5073
(313) 622-9544
Mailing address
35594 CONCORD DR, ROMULUS, MI 48174-6349
(313) 622-9544
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704241363
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
MI
Enumeration date
01/13/2021
Last updated
08/30/2021
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