MEDICARE: STARQUISHA MONA BLACK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide		MI

General Provider Information

NPI Number	:	1346189008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STARQUISHA MONA BLACK

Provider Business Mailing Address
First Line	:	13205 JOY RD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48228-2537
Country	:	US
Telephone Number	:	616-676-7611
Fax Number	:

Provider Business Practice Location Address
First Line	:	13205 JOY RD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48228-2537
Country	:	US
Telephone Number	:	616-676-7611
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2026
Last Update Date	:	03/27/2026

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Directions to “ STARQUISHA MONA BLACK ” Practice Location

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