Provider Demographics
NPI:1386364537
Name:BOOKER, MARKIEA TWALISHA
Entity type:Individual
Prefix:
First Name:MARKIEA
Middle Name:TWALISHA
Last Name:BOOKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARKIEA
Other - Middle Name:TWALISHA
Other - Last Name:BOOKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MISS KIEA
Mailing Address - Street 1:6781 IOWA ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48212-1423
Mailing Address - Country:US
Mailing Address - Phone:586-696-4461
Mailing Address - Fax:
Practice Address - Street 1:6781 IOWA ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48212-1423
Practice Address - Country:US
Practice Address - Phone:586-696-4461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIB260585807797376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker