Individual
MRS. ANDREA CONSTANCE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
100 MEADOWS CIR S, WIXOM, MI 48393-3950
(947) 800-6017
Mailing address
100 MEADOWS CIR S, WIXOM, MI 48393-3950
(947) 800-6017
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2021117524
MI
Other
Enumeration date
12/24/2021
Last updated
12/24/2021
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