Individual
MRS. KATHY LYNN LEIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5333 MCAULEY DR, YPSILANTI, MI 48197-1014
(734) 712-3470
Mailing address
23046 FAIRLANE BLVD, WOODHAVEN, MI 48183-1688
(734) 308-5914
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704164321
MI
Other
Enumeration date
10/18/2008
Last updated
10/18/2008
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