Individual
MS. NECOLA SELENA TABLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4909 E OUTER DR, DETROIT, MI 48234-3446
(313) 366-2000
(313) 447-1582
Mailing address
4909 E OUTER DR, DETROIT, MI 48234-3446
(313) 366-2000
(313) 447-1582
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704250204
MI
Other
Enumeration date
10/17/2020
Last updated
05/08/2026
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