Individual
GLORIA JEAN FADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1561 M 30, ALGER, MI 48610-8538
(989) 965-5123
Mailing address
1561 M 30, ALGER, MI 48610-8538
(989) 965-5123
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703065206
MI
Other
Enumeration date
02/20/2019
Last updated
02/20/2019
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