Individual
JACLYN SUZETTE KOURNOIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1000 HARRINGTON ST, MOUNT CLEMENS, MI 48043-2920
(586) 690-9062
Mailing address
42577 GREYSTONE DR, STERLING HEIGHTS, MI 48313-2990
(586) 480-9383
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704234791
MI
Other
Enumeration date
10/20/2009
Last updated
03/04/2014
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