Individual
RITA J DIBIASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
4100 JOHN R ST, DETROIT, MI 48201-2013
(800) 527-6266
(313) 576-8627
Mailing address
PO BOX 775419, CHICAGO, IL 60677-5419
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704138510
MI
Other
Enumeration date
01/23/2019
Last updated
03/04/2019
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