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Individual

JENNIFER WEDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
4100 JOHN R ST, DETROIT, MI 48201-2013
(800) 527-6266
(313) 966-0752
Mailing address
3990 JOHN R ST # 10WN, DETROIT, MI 48201-2018
(313) 576-8049

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704226381
MI

Other

Enumeration date
03/29/2007
Last updated
07/08/2007
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