Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 4704272018 | MI |
NPI | 1063816742 |
---|---|
Provider Name | Ms. Sheri Houghland |
First Address | Redford, MI 48239-1854 |
Second Address | Westland, MI 48185-1137 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2014 |
Last Update Date | 15/06/2020 |