Individual
SITHARA JAISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P
Contact information
Practice address
426 WESTBROOK, WHITMORE LAKE, MI 48189-8211
(734) 550-2002
Mailing address
426 WESTBROOK, WHITMORE LAKE, MI 48189-8211
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704268025
MI
363LF0000X
Family Nurse Practitioner
Primary
4704268025
MI
Other
Enumeration date
01/28/2015
Last updated
02/20/2018
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