Individual
KISHA MAIRE MURRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12866 FORT ST, SOUTHGATE, MI 48195-1060
(734) 720-7920
Mailing address
12866 FORT ST, SOUTHGATE, MI 48195-1060
(734) 720-7920
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
4704360270
MI
Other
Enumeration date
04/04/2026
Last updated
04/09/2026
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