Individual
PATRICIA JEAN HAVERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9009 GRAYTON ST, DETROIT, MI 48224-1900
(313) 469-1359
Mailing address
899 WEBB ST, DETROIT, MI 48202-1024
(313) 802-5115
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704284652
MI
Other
Enumeration date
02/28/2018
Last updated
04/18/2022
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