Ezenwokemodo, Marie Michelle

Ezenwokemodo, Marie Michelle is an individual health care provider with primary practice located at 6223 N Canton Center Rd Ste 201 , Canton MI 48187-2696. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Ezenwokemodo, Marie Michelle can be contacted via phone (734) 844-6533.

Contact Information

Primary practice address
6223 N Canton Center Rd Ste 201 Canton MI 48187-2696
Phone: (734) 844-6533
Fax: (734) 667-5079
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 4703110083 Michigan

Profile Details

NPI number 1710365481
LBN Legal business name Ezenwokemodo, Marie Michelle
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 13th, 2015
Last updated May 13th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710365481 NPPES
Michigan MEDICAID 4360685

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