Individual
KRISTYN OLIVIA SEVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5301 MCAULEY DR, YPSILANTI, MI 48197-1051
(734) 712-3456
Mailing address
742 MAURY PL, HOWELL, MI 48843-9133
(734) 478-0137
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601008719
MI
Other
Enumeration date
07/24/2018
Last updated
03/22/2023
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