Individual provider · NPI-1

Lawanda Hicks Agbassi, NP

Nurse Practitioner, Family · Livonia, MI

NPI number1083638993
StatusActive
Last updated in NPPESAug 1, 2016

Details

NPI
1083638993
Entity type
Individual (NPI-1)
Name
Lawanda Hicks Agbassi
Credential
NP
Sex
Female
Sole proprietor
No
Enumeration date
Jul 26, 2006
Last updated
Aug 1, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family4704163985MIYes

Practice location

15357 Farmington Rd
Suite 2
Livonia, MI 48154-2863

Phone 313-282-4527

Mailing address

8586 Buckland Dr
South Lyon, MI 48178-9616

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