Individual
KYLE KRUPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2600
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 874-4806
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704276038
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704276038
LICENSE
MI
Enumeration date
09/17/2014
Last updated
01/29/2024
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