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Individual

JUDITH ELLEN WEED

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 788-4958
(517) 796-6410
Mailing address
DEPARTMENT 272801, PO BOX 67000, DETROIT, MI 48267-0001
(517) 841-6913
(517) 841-6917

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704151052
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4185020
MI
Enumeration date
06/13/2006
Last updated
07/09/2007
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