NPI 1023800562

Burshonda Wilson

Practitioner Driver Warren, MI

Practice location

Address: 13217 Frazho Rd, Warren, MI 48089-1302
Phone: (313) 977-7544

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence OQLQ56 (MI)

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Registry record

NPI: 1023800562
Entity type: Individual
Sex (as registered): Female
NPI issued: 20 May 2025
Record last updated: 20 May 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.