Individual
JAMIE RATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9790 DALEVIEW DR, SOUTH LYON, MI 48178-9108
(313) 461-1869
Mailing address
9790 DALEVIEW DR, SOUTH LYON, MI 48178-9108
(313) 461-1869
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704311619
MI
363LA2100X
Acute Care Nurse Practitioner
2020037427
MI
363LA2100X
Acute Care Nurse Practitioner
Primary
4704311619
MI
Other
Enumeration date
04/30/2020
Last updated
02/17/2022
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