Provider Demographics
NPI:1932695939
Name:POZEY-ENGINE, GLORIA JEAN (NURSE)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:JEAN
Last Name:POZEY-ENGINE
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26024 REGENCY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48089-1551
Mailing Address - Country:US
Mailing Address - Phone:586-913-1194
Mailing Address - Fax:
Practice Address - Street 1:1221 E GRAND BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48211-3428
Practice Address - Country:US
Practice Address - Phone:313-720-1757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703062469164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse