Healthcare Provider Details

I. General information

NPI: 1861930448
Provider Name (Legal Business Name): SHERMANSTINE MORROW LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2017
Last Update Date: 02/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13901 E JEFFERSON AVE
DETROIT MI
48215-2720
US

IV. Provider business mailing address

13901 E JEFFERSON AVE
DETROIT MI
48215-2720
US

V. Phone/Fax

Practice location:
  • Phone: 313-897-7700
  • Fax: 313-897-5591
Mailing address:
  • Phone: 313-897-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number4703108736
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: