Individual
MISS KATIE LENORE CLANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4350 DIXIE HWY, WATERFORD, MI 48329-3506
(248) 674-0466
Mailing address
6467 WILSON DR, WATERFORD, MI 48329-3176
(248) 722-4344
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704288350
MI
Other
Enumeration date
05/11/2021
Last updated
05/11/2021
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