Healthcare Provider Details

I. General information

NPI: 1154649432
Provider Name (Legal Business Name): BATRICE JONES II
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 05/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

571 PALMERSTON ST
RIVER ROUGE MI
48218-1169
US

IV. Provider business mailing address

571 PALMERSTON ST
RIVER ROUGE MI
48218-1169
US

V. Phone/Fax

Practice location:
  • Phone: 313-244-6280
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number4704226877
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: