Individual
MRS. KELLIE RAE KROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
8623 N WAYNE RD STE 123, WESTLAND, MI 48185-1137
(734) 367-0469
Mailing address
1992 WILTSHIRE RD, BERKLEY, MI 48072-3313
(248) 320-4828
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704294238NSA2001Q
MI
Other
Enumeration date
04/22/2021
Last updated
04/22/2021
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