Individual
KELLY MAGRUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
650 STEWART RD, MONROE, MI 48162-4222
(734) 240-8430
Mailing address
650 STEWART RD, MONROE, MI 48162-4222
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
4704260469
MI
363LF0000X
Family Nurse Practitioner
Primary
4704260469
MI
Other
Enumeration date
03/23/2016
Last updated
04/02/2026
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