Individual
MRS. CASSANDRA KONDYLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNPC-AG
Contact information
Practice address
6777 W MAPLE RD, WEST BLOOMFIELD, MI 48322-3013
(800) 653-6568
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 874-4806
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
APRN.CNP.0034294
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
4704425980
MI
Other
Enumeration date
07/10/2023
Last updated
12/09/2025
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