Doctor Name: | JILLIAN MICHELLE FENNER |
NPI Number: | 1417304254 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 17321 Telegraph Rd Detroit, MI - 482193132 |
Business Phone Number: | 3133248557 |
Business Fax Number: | |
Mailing Address: | 2166 Beaufait Dr, GROSSE POINTE WOODS |
State: | MI |
Postal Code: | 482361643 |
Phone Number: | 3135201386 |
Fax Number: | |
NPI Enumeration Date: | 05/23/2016 |
NPI Last Update Date: | 05/23/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 247200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Technician, Other |
Taxonomy Specialization: | |
Taxonomy Definition: | A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user. |