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Individual

GWENDOLYN FIELDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
14799 DIX TOLEDO RD, SOUTHGATE, MI 48195-2507
(734) 324-8326
Mailing address
PO BOX 24754, DETROIT, MI 48224-0754
(313) 680-4094

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704241900
MI

Other

Enumeration date
03/09/2021
Last updated
11/03/2023
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