Individual
KRISLI ANDONI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
1400 VFW PKWY, WEST ROXBURY, MA 02132-4927
(857) 203-3479
Mailing address
259 MACK AVE, DETROIT, MI 48201-2427
(586) 214-8076
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601011183
MI
Other
Enumeration date
06/23/2022
Last updated
11/06/2025
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