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Individual

KIMBERLY MATTINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
26206 W 12 MILE RD STE 105, SOUTHFIELD, MI 48034-1799
(248) 200-3715
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704306684
MI

Other

Enumeration date
06/30/2014
Last updated
09/07/2023
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