Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 4704309288 | MI |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 4704309288 | MI |
NPI | 1346738507 |
---|---|
Provider Name | Jozelynn Guinn Worden |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-4254 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2018 |
Last Update Date | 17/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4704309288 | STATE OF MICHIGAN (01) | MI |