Basic Information
| Provider Information | |||||||||
| NPI: | 1285976944 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARNER | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | LOU | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18751 FITZPATRICK ST | ||||||||
| Address2: | APT A6 | ||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482281484 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3133184969 | ||||||||
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| Practice Location | |||||||||
| Address1: | 13101 ALLEN RD | ||||||||
| Address2: | |||||||||
| City: | SOUTHGATE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481952216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7347857700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2013 | ||||||||
| LastUpdateDate: | 03/20/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 172V00000X | H520622549660 | MI | Y | Other Service Providers | Community Health Worker |
No ID Information.