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Individual

MRS. KELLY RENEE THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
1921 E MILLER RD, LANSING, MI 48911-5348
(517) 319-0700
Mailing address
1921 E MILLER RD, LANSING, MI 48911-5348
(517) 319-0700

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704263759
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4704263759
RN LICENSE
MI
Enumeration date
01/17/2021
Last updated
05/10/2021
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