Individual
STEPHANIE LYNN KANGAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2600
Mailing address
1338 OXFORD RD, BERKLEY, MI 48072-2074
(248) 563-9355
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704249196
MI
Other
Enumeration date
03/12/2012
Last updated
03/12/2012
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