Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 4704141647 | MI |
NPI | 1013015155 |
---|---|
Provider Name | Wendy Storey |
First Address | Ann Arbor, MI 48105-9484 |
Second Address | Canton, MI 48187-4849 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 02/01/2017 |