Individual
MS. DIANE KENDRICK-JEFFERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2051 W GRAND BLVD, DETROIT, MI 48208-1105
(131) 396-1378
(131) 396-1376
Mailing address
2051 W GRAND BLVD, DETROIT, MI 48208-1105
(131) 396-1378
(131) 396-1376
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704120743
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704120743
STATE LICENSE NUMBER
MI
Enumeration date
07/19/2007
Last updated
07/19/2007
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