Individual
MR. KEVAN SCOTT MAGUIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1105 6TH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-5000
Mailing address
1105 6TH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-5000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704283338
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4704283338
—
MI
Enumeration date
02/09/2018
Last updated
12/23/2020
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