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NPI Code Detail

MEDICARE: SABRINA BENN

MEDICARE: SABRINA BENN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WA0400XAddiction (Substance Use Disorder) Registered Nurse4704245056MI

General Provider Information

NPI Number : 1144001553
Entity Type Code : Individual
Provider Name (Legal Business Name) : SABRINA BENN
Provider Business Mailing Address
First Line : 12637 GRAYFIELD ST
Second Line :
City : DETROIT
State : MI
Zip : 48223-3035
Country : US
Telephone Number : 313-231-3141
Fax Number :
Provider Business Practice Location Address
First Line : 300 W MCNICHOLS RD
Second Line :
City : DETROIT
State : MI
Zip : 48203-2703
Country : US
Telephone Number : 313-867-8015
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2023
Last Update Date : 10/11/2023

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Directions to “ SABRINA BENN ” Practice Location

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