Individual
DR. HALEY NICOLE WANIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, A-GNP
Contact information
Practice address
14165 N FENTON RD STE 201A, FENTON, MI 48430-1584
(810) 853-5875
(586) 279-4515
Mailing address
14165 N FENTON RD STE 201A, FENTON, MI 48430-1584
(108) 535-8758
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704356520
MI
Other
Enumeration date
06/25/2022
Last updated
11/10/2022
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