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Marie Michelle Ezenwokemodo
Licensed Practical Nurse in Canton, Michigan
NPI 1710365481

Marie Michelle Ezenwokemodo is a Licensed Practical Nurse based in Canton, MI. Marie Michelle Ezenwokemodo practices in Canton, MI. The NPI Number for Marie Michelle Ezenwokemodo is 1710365481 and holds a License No. 4703110083 (Michigan).

The current practice location address for Marie Michelle Ezenwokemodo is 6223 N Canton Center Rd Ste 201, Canton, MI and can be reached out via phone at 734-844-6533 and via fax at 734-667-5079.

Location: 6223 N Canton Center Rd Ste 201, Canton, MI, 48187-2696
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1710365481
Provider Name
Marie Michelle Ezenwokemodo
Credential
Provider Entity Type
Individual
Gender
Female
Address
6223 N Canton Center Rd Ste 201, Canton, MI, 48187-2696
Phone Number
734-844-6533
Fax Number
734-667-5079
Provider Enumeration Date
05/13/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4360685 05 MI
institution
Provider Business Practice Location Address Details
Address
6223 N Canton Center Rd Ste 201
City
Canton
State
Michigan
Zip
48187-2696
Phone Number
734-844-6533
Fax Number
734-667-5079
person
Provider Business Mailing Address Details
Address
6223 N Canton Center Rd Ste 201
City
Canton
State
Michigan
Zip
48187-2696
Phone Number
734-844-6533
Fax Number
734-667-5079
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Practical Nurse
Speciality
-
Taxonomy
164W00000X
License No.
4703110083 (Michigan)
Definition
An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
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