Individual
KELLY KINSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
718 N MACOMB ST, SUITE 225, MONROE, MI 48162-7815
(734) 242-2081
Mailing address
12158 N LAKESHORE DR, LA SALLE, MI 48145-9733
(734) 242-2081
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704280878
MI
Other
Enumeration date
07/17/2014
Last updated
07/17/2014
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