STACEY LYNN BLACK-SHAW

DETROIT, MI
NPI1346093184
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy163WC0200X Registered Nurse, Critical Care Medicine
(Licence: MI  4704282646)
Enumeration Date2024-04-10
Last Update Date2024-04-10
Business Address
STACEY LYNN BLACK-SHAW
4646 JOHN R ST
DETROIT, MI 48201-1916
Phone number: 313-576-1000
Mailing Address
STACEY LYNN BLACK-SHAW
17515 WILDEMERE ST
DETROIT, MI 48221-2724
Phone number: 313-570-9046
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