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1124147020
JANIS ILLSON
DETROIT, MI
NPI
1124147020
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: MI 4704106883)
Enumeration Date
2007-03-29
Last Update Date
2007-07-08
Business Address
JANIS ILLSON CRNA
6071 W OUTER DR
DETROIT, MI 48235-2624
Phone number: 313-966-3300
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Mailing Address
JANIS ILLSON CRNA
28500 ORCHARD LAKE RD
FARMINGTON HILLS, MI 48334-2936
Phone number: 248-851-6767
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