Provider Demographics
NPI:1417700931
Name:ALBRITTON, GEORGETTA
Entity Type:Individual
Prefix:
First Name:GEORGETTA
Middle Name:
Last Name:ALBRITTON
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 1:6122 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-2514
Mailing Address - Country:US
Mailing Address - Phone:313-608-2091
Mailing Address - Fax:
Practice Address - Street 1:6122 CHARLES ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-2514
Practice Address - Country:US
Practice Address - Phone:313-608-2091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker