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Organization

ELAN VITALE HEALTHY LIVING SOLUTIONS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JACKIE DUNCAN PMHNP (NURSE PRACTITIONER)
(248) 667-2531
Entity
Organization

Contact information

Practice address
27247 JOY RD, DEARBORN HTS, MI 48127-1022
(248) 667-6307
Mailing address
27247 JOY RD, DEARBORN HTS, MI 48127-1022

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704170920
MI

Other

Enumeration date
03/14/2018
Last updated
03/14/2018
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