Individual
MARILYN ELIZABETH REMILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
400 MACK AVE, DETROIT, MI 48201-2136
(313) 579-5047
(313) 578-6391
Mailing address
9759 HOUGHTON ST, LIVONIA, MI 48150-2429
(734) 464-3452
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704201199
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704201199
PROFESSIONAL LICENSE
MI
Enumeration date
01/18/2007
Last updated
07/08/2007
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