Individual
MS. MARY JEAN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N., PHN, B.S.N.
Contact information
Practice address
1151 TAYLOR ST, ROOM 332-C, DETROIT, MI 48202-1732
(313) 876-0360
Mailing address
1151 TAYLOR ST, BLDG 6, ROOM 117, DETROIT, MI 48202-1732
(313) 876-4149
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704089180
MI
Other
Enumeration date
08/15/2008
Last updated
08/15/2008
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