Individual
ALETHEA FENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
19352 MARX ST, DETROIT, MI 48203-1338
(313) 399-0611
Mailing address
19352 MARX ST, DETROIT, MI 48203
(313) 399-0611
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704397418
MI
164W00000X
Licensed Practical Nurse
4703116076
MI
Other
Enumeration date
11/23/2016
Last updated
07/31/2023
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