Provider Demographics
NPI:1184808966
Name:GARVIN, ANN DAVIS (CNM)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:DAVIS
Last Name:GARVIN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20548 FENKELL ST
Mailing Address - Street 2:ATTN: CARMAN HUGHES
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48223-1613
Mailing Address - Country:US
Mailing Address - Phone:313-255-3333
Mailing Address - Fax:
Practice Address - Street 1:2395 W GRAND BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48208-1210
Practice Address - Country:US
Practice Address - Phone:313-897-2061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704107557367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife