Healthcare Provider Details

I. General information

NPI: 1356717458
Provider Name (Legal Business Name): DALONDA GRIER R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2015
Last Update Date: 08/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2925 RUSSELL ST
DETROIT MI
48207-4825
US

IV. Provider business mailing address

2925 RUSSELL STREET
DETROIT MI
48207
US

V. Phone/Fax

Practice location:
  • Phone: 313-369-5300
  • Fax:
Mailing address:
  • Phone: 313-369-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704290317
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: