Individual
JENNA FIRESTONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21034 BOULDER CIR, NORTHVILLE, MI 48167-2736
(248) 949-9036
Mailing address
21034 BOULDER CIR, NORTHVILLE, MI 48167-2736
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704363638
MI
Other
Enumeration date
04/02/2026
Last updated
04/02/2026
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