Individual
KAREN STANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN BSN
Contact information
Practice address
751 E GRAND BLVD, DETROIT, MI 48207-2529
(313) 922-2222
Mailing address
751 E GRAND BLVD, DETROIT, MI 48207-2529
(313) 922-2222
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
4704204295
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558493916
—
MI
Enumeration date
01/17/2018
Last updated
01/17/2018
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