Individual
JENEANE L HENDERSON-SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Mailing address
22065 HURON RIVER DR APT 215, ROCKWOOD, MI 48173-1177
(734) 643-1349
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703097607
MI
Other
Enumeration date
12/05/2024
Last updated
12/05/2024
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