THEODORA GIST

Community Health Worker

Active Individual
NPI: 1184503401

Practice Address

5555 CONNER ST
Detroit, MI 48213

Phone: (313) 687-3633

Specialties

Specialty Code Primary License
Community Health Worker 172V00000X Yes -

Frequently Asked Questions

NPI 1184503401 is the National Provider Identifier for THEODORA GIST, a Community Health Worker provider located in Detroit, MI. This NPI was enumerated on August 29, 2025.
THEODORA GIST practices at 5555 CONNER ST, Detroit, MI 48213.

Quick Facts

NPI
1184503401
Type
Individual
Enumerated
Aug 29, 2025
Last Updated
Aug 29, 2025

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