Individual
EMILY BRIDGET FALLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 900-2340
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001274462
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
4704324063
MI
Other
Enumeration date
04/06/2023
Last updated
04/08/2024
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