Individual
MRS. HEATHER EVELYN NYSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP-BC
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-0467
(313) 916-9485
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-0467
(313) 916-9485
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
4704203209
MI
Other
Enumeration date
11/28/2009
Last updated
11/23/2022
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