Individual
MICHELLE MARIE TRUDEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP MS RN
Contact information
Practice address
21401 MACK AVE, GROSSE POINTE WOODS, MI 48236-1048
(734) 464-0887
(734) 402-0254
Mailing address
36123 SCHOOLCRAFT RD, LIVONIA, MI 48150-1216
(734) 793-6140
(865) 560-8948
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704174038
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500F318890
BCBS
MI
Enumeration date
03/01/2006
Last updated
11/16/2017
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