Individual
KIMBERLY DAWN ROOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
3901 BEAUBIEN ST, DETROIT, MI 48201-2119
(313) 745-5750
(313) 831-3908
Mailing address
3901 BEAUBIEN ST, DETROIT, MI 48201-2119
(313) 745-5750
(313) 831-3908
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704162094
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4517881
—
MI
01
—
5008601810
BLUE CROSS/BLUE SHIELD
MI
Enumeration date
10/03/2005
Last updated
02/09/2012
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