Individual
MS. SHERENDA NICOLE FAUSNAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDMT
Contact information
Practice address
5195 S 148TH AVE, HESPERIA, MI 49421-9546
(313) 258-3114
Mailing address
PSC 80 BOX 22495, APO, AP 96367-0109
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
01/06/2012
Last updated
03/28/2013
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