Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 4704180738 | MI |
NPI | 1083050132 |
---|---|
Provider Name | Janet Ann Pizzino |
First Address | Allen Park, MI 48101 |
Second Address | Detroit, MI 48201-2119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2013 |
Last Update Date | 16/05/2013 |