Individual
MCKENNA NICOLE MARDLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC, EMT, OPE-C
Contact information
Practice address
4001 W MCNICHOLS RD, DETROIT, MI 48221-3038
(313) 623-2109
Mailing address
1161 QUAIL RIDGE DR, OXFORD, MI 48371-6075
(248) 807-1577
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
2017040
MI
2255A2300X
Athletic Trainer
Primary
2601003117
MI
Other
Enumeration date
01/18/2024
Last updated
06/19/2025
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