NPI 1104609692

Chantille Luckett

Practitioner Nurse's Aide Warren, MI

Practice location

Address: 27817 Yvette Dr, Warren, MI 48088-6647
Phone: (313) 544-8101

Registered specialties

Nurse's Aide Primary

Nursing Service Related Providers Taxonomy 376K00000X Licence 230014969350410 (MI)

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Registry record

NPI: 1104609692
Entity type: Individual
Sex (as registered): Female
NPI issued: 17 Aug 2023
Record last updated: 17 Aug 2023

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.