Individual
PATRICIA POLENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
6742 PARK AVE, ALLEN PARK, MI 48101-2034
(313) 928-2333
Mailing address
6742 PARK AVE, ALLEN PARK, MI 48101-2034
(313) 928-2333
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4707160076
MI
Other
Enumeration date
09/09/2007
Last updated
03/18/2019
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