SHANISE YVONNE PETTICORD

DETROIT, MI
NPI1700639101
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: MI  4703091434)
Enumeration Date2024-04-08
Last Update Date2024-04-08
Business Address
SHANISE YVONNE PETTICORD
5736 AUDUBON RD
DETROIT, MI 48224-2665
Phone number: 313-624-1067
Mailing Address
SHANISE YVONNE PETTICORD
5736 AUDUBON RD
DETROIT, MI 48224-2665
Phone number: 313-624-1067
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