Individual
MARY ELLEN CROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12777 GRACE CT, GRAND BLANC, MI 48439-1522
(810) 423-1761
Mailing address
12777 GRACE CT, GRAND BLANC, MI 48439-1522
(810) 423-1761
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704204846
MI
Other
Enumeration date
04/07/2017
Last updated
04/07/2017
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