Individual
KELLY NIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2689
(313) 916-2600
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
Primary
4704348158
MI
363LC0200X
Critical Care Medicine Nurse Practitioner
4704348158
MI
363LG0600X
Gerontology Nurse Practitioner
4704348158
MI
Other
Enumeration date
07/09/2024
Last updated
09/03/2025
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