Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LG0600X | Nurse Practitioner - Gerontology | 4704313968 | MI |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 4704313968 | MI |
N | 363LP2300X | Nurse Practitioner - Primary Care | 4704313968 | MI |
NPI | 1073123501 |
---|---|
Provider Name | Genevieve Elizabeth Sweeney |
First Address | Fenton, MI 48430-3479 |
Second Address | Ypsilanti, MI 48197-1104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2020 |
Last Update Date | 27/09/2020 |