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General NPI Number Information
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NPI Number | 1801427745
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Entity Type | Individual
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Provider Name | JESSICA SOKANA
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Gender | Female
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Dates
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Enumeration Date | 01/29/2020
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Last Update Date | 01/29/2020
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Provider Practice Location Address
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Address Line | 13475 15 MILE RD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48312-4214
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Country | US
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Telephone | 586-268-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 3834 MARTIN RD
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City | WARREN
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State | MI
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Zip | 48092-4102
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Country | US
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Telephone | 586-429-5090
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302042960
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License Number State | MI
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