Individual
INESSA GANKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
28701 PLYMOUTH RD, LIVONIA, MI 48150
(734) 427-9900
(734) 427-8963
Mailing address
28701 PLYMOUTH RD, LIVONIA, MI 48150
(734) 427-9900
(734) 427-8963
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704226176
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C00882
MEDICARE RAILROAD PIN
MI
Enumeration date
08/31/2006
Last updated
05/20/2008
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