Individual
KIMBERLY KAY LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
13342 WHITE LAKE RD, FENTON, MI 48430-8401
(810) 278-6646
Mailing address
13342 WHITE LAKE RD, FENTON, MI 48430-8401
(810) 278-6646
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704224018
MI
Other
Enumeration date
08/31/2022
Last updated
08/31/2022
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