Individual
MRS. MELANIE FRAGOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
36475 FIVE MILE RD, LIVONIA, MI 48154-1971
(734) 655-4800
Mailing address
15 E KIRBY ST APT 1031, DETROIT, MI 48202-4043
(248) 345-9932
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704296999NSA17640
MI
Other
Enumeration date
01/09/2018
Last updated
01/09/2018
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