Individual
JALISA ANN DONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
26798 EAST CARNEGIE DR, SOUTHFIELD, MI 48034
(947) 900-1723
Mailing address
26798 EAST CARNEGIE DR, SOUTHFIELD, MI 48034
(947) 900-1723
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703122990
MI
Other
Enumeration date
05/08/2023
Last updated
05/08/2023
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