Individual
MS. KELLY ANN MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-BC, CDE
Contact information
Practice address
3031 W GRAND BLVD, SUITE 800 ENDO METAB, DETROIT, MI 48202-3046
(313) 916-3906
(313) 916-3907
Mailing address
3031 W GRAND BLVD STE 800, DETROIT, MI 48202-3141
(313) 916-3906
(313) 916-3907
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
4704175148
MI
363LF0000X
Family Nurse Practitioner
Primary
4704175148
MI
Other
Enumeration date
02/15/2007
Last updated
09/27/2010
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