Individual
KAITLYN THEBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1355 BOGUE ST, EAST LANSING, MI 48824-6207
(517) 432-8163
Mailing address
1666 WINTERCREST ST, EAST LANSING, MI 48823-1761
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704364447
MI
Other
Enumeration date
06/03/2025
Last updated
06/03/2025
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