Individual
SOURIYA KEJJAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
936 VINCENT CT, LANSING, MI 48910-5115
(517) 899-2689
Mailing address
936 VINCENT CT, LANSING, MI 48910-5115
(517) 899-2689
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703113554
MI
Other
Enumeration date
02/17/2015
Last updated
02/17/2015
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