Individual
KIMBERLY O'SHAUGHNESSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
39450 W 12 MILE RD, NOVI, MI 48377-3600
(248) 344-6688
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 874-4806
Taxonomy
Speciality
Code
Description
License number
State
163WX0200X
Oncology Registered Nurse
4704285718
MI
363LG0600X
Gerontology Nurse Practitioner
4704285718
MI
363LP2300X
Primary Care Nurse Practitioner
Primary
4704285718
MI
Other
Enumeration date
05/01/2020
Last updated
12/20/2022
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