Healthcare Provider Details

I. General information

NPI: 1124381462
Provider Name (Legal Business Name): JENNATA FRANCIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18325 E 10 MILE RD STE 100
ROSEVILLE MI
48066-4990
US

IV. Provider business mailing address

18325 E 10 MILE RD STE 100
ROSEVILLE MI
48066-4990
US

V. Phone/Fax

Practice location:
  • Phone: 586-776-1010
  • Fax: 586-776-0364
Mailing address:
  • Phone: 586-776-1010
  • Fax: 586-776-0364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301100863
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: