Individual
MRS. KELLI ANN PAGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
23660 EUREKA RD, TAYLOR, MI 48180-5275
(734) 250-9630
(734) 250-9631
Mailing address
23660 EUREKA RD, TAYLOR, MI 48180-5275
(734) 250-9630
(734) 250-9631
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005021
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601005021
STATE LICENSE NUMBER
MI
Enumeration date
05/17/2007
Last updated
12/04/2023
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