Provider Demographics
NPI:1962952705
Name:LEFLORE, JOANN
Entity type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:
Last Name:LEFLORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20461 INDIAN
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-1209
Mailing Address - Country:US
Mailing Address - Phone:313-693-0306
Mailing Address - Fax:
Practice Address - Street 1:20461 INDIAN
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240-1209
Practice Address - Country:US
Practice Address - Phone:313-693-0306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI230004905020207376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide