person
Boni S Koithara, NP
Family Nurse Practitioner in Detroit, Michigan
NPI 1629746813

Boni S Koithara is a Family Nurse Practitioner based in Detroit, MI and is specialized in Family. Boni S Koithara practices in Detroit, MI and has the professional credentials of NP. The NPI Number for Boni S Koithara is 1629746813 and holds a License No. 4704237388 (Michigan).

The current practice location address for Boni S Koithara is 311 Mack Ave, Detroit, MI and can be reached out via phone at 313-745-3000.

Location: 311 Mack Ave, Detroit, MI, 48201-2466
person
Provider Profile Details
NPI Number
1629746813
Provider Name
Boni S Koithara
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
311 Mack Ave, Detroit, MI, 48201-2466
Phone Number
313-745-3000
Fax Number
Provider Enumeration Date
09/01/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
311 Mack Ave
City
State
Zip
48201-2466
Phone Number
313-745-3000
Fax Number
person
Provider Business Mailing Address Details
Address
311 Mack Ave
City
State
Zip
48201-2466
Phone Number
313-745-3000
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
4704237388 (Michigan)
Definition
Definition to come...
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