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General NPI Number Information
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NPI Number | 1477443539
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Entity Type | Individual
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Provider Name | MARISA LYNN GHESQUIERE MSN, RN
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Gender | Female
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 3950 BEAUBIEN ST
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City | DETROIT
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State | MI
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Zip | 48201-2166
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Country | US
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Telephone | 313-832-9395
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Fax | 313-966-7445
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Provider Business Mailing Address
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Address Line | 76 S MAIN ST
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City | MOUNT CLEMENS
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State | MI
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Zip | 48043-2380
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Country | US
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Telephone | 586-222-5784
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704365093
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License Number State | MI
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