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Individual

MRS. IRENE JUDITH SUN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP, CRNA

Contact information

Practice address
11800 E 12 MILE RD, WARREN, MI 48093-3472
(586) 573-5059
Mailing address
27200 OXBOW LAKE DR, CHESTERFIELD, MI 48051-1683
(586) 879-8936

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
4704177851
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704177851
MI

Other

Enumeration date
06/06/2006
Last updated
11/19/2012
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