Individual
MAGGIE JANISSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
4100 JOHN R ST, DETROIT, MI 48201-2013
(800) 527-6266
(313) 576-8381
Mailing address
1560 E MAPLE RD, SUITE 400 - CREDENTIALING, TROY, MI 48083-1138
(800) 527-6266
(313) 576-8381
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704283330
MI
Other
Enumeration date
12/09/2015
Last updated
01/30/2017
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