Individual
DENA Y ESSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2454 MONROE ST STE A, DEARBORN, MI 48124-3038
(313) 562-4100
(313) 562-4590
Mailing address
2454 MONROE ST STE A, DEARBORN, MI 48124-3038
(313) 562-4100
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704297825
MI
Other
Enumeration date
05/10/2021
Last updated
05/10/2021
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