Individual
SALLY M KIDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
535 S BURDICK ST STE 256, KALAMAZOO, MI 49007-6112
(269) 352-9977
Mailing address
5106 FOUNTAIN SQUARE DR, KALAMAZOO, MI 49009-9531
(269) 352-9977
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
4704239762
MI
Other
Enumeration date
04/09/2020
Last updated
04/09/2020
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