Individual
JEREMY KUDZIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
25401 HARPER AVE STE 2, SAINT CLAIR SHORES, MI 48081-2248
(586) 469-6912
Mailing address
42383 GARFIELD RD UNIT 381131, CLINTON TOWNSHIP, MI 48038-7737
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704307001
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
4704307001
MI
Other
Enumeration date
08/19/2014
Last updated
01/06/2025
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