Individual
JISHA DUDEESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
44555 WOODWARD AVE, PONTIAC, MI 48341
(248) 858-6104
Mailing address
24 FRANK LLOYD WRIGHT DRIVE, SUITE J2000, ANN ARBOR, MI 48105
(734) 747-6766
(734) 222-3100
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704256647
MI
363LG0600X
Gerontology Nurse Practitioner
4704256647
MI
Other
Enumeration date
10/10/2016
Last updated
12/13/2024
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