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Individual

TINA KILLIANY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
10220 OAK PARK BLVD, OAK PARK, MI 48237-2257
(786) 458-1786
Mailing address
10220 OAK PARK BLVD, OAK PARK, MI 48237-2257
(786) 458-1786

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703119347
MI

Other

Enumeration date
10/04/2019
Last updated
10/04/2019
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