Individual
MARY ANN DEBACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 615-3217
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704300013
MI
363L00000X
Nurse Practitioner
Primary
4704300013
MI
Other
Enumeration date
12/16/2020
Last updated
05/27/2022
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