Individual
JASMINE S KIRYAKOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
15101 GOLDEN AVE, WALLED LAKE, MI 48390-2693
(248) 904-9809
Mailing address
15101 GOLDEN AVE, WALLED LAKE, MI 48390-2693
(248) 904-9809
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F11250156
MI
Other
Enumeration date
11/07/2025
Last updated
11/07/2025
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