Healthcare Provider Details

I. General information

NPI: 1922935915
Provider Name (Legal Business Name): JENNIFER MARIE MARVIN CAREGIVER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25985 MARITIME CIR S
HARRISON TOWNSHIP MI
48045-3076
US

IV. Provider business mailing address

25985 MARITIME CIR S
HARRISON TOWNSHIP MI
48045-3076
US

V. Phone/Fax

Practice location:
  • Phone: 586-770-6499
  • Fax:
Mailing address:
  • Phone: 586-770-6499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: