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NPI Code Detail

MEDICARE: MS. JUANITA CLARITA DENISE FISH

MEDICARE: MS. JUANITA CLARITA DENISE FISH
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
13747P1801XPersonal Care AttendantMI

General Provider Information

NPI Number : 1730017344
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JUANITA CLARITA DENISE FISH
Provider Business Mailing Address
First Line : 20180 KLINGER ST
Second Line :
City : DETROIT
State : MI
Zip : 48234-1744
Country : US
Telephone Number : 313-243-6508
Fax Number :
Provider Business Practice Location Address
First Line : 20180 KLINGER ST
Second Line :
City : DETROIT
State : MI
Zip : 48234-1744
Country : US
Telephone Number : 313-243-6508
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2026
Last Update Date : 05/12/2026

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