Individual
JESSICA A BAIR SUKARUKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-4021
(248) 898-1473
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704274995
MI
Other
Enumeration date
07/06/2016
Last updated
04/10/2024
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