Individual
KYLIE PETZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
920 DIANA ST, LUDINGTON, MI 49431-1987
(231) 845-6294
(231) 845-7095
Mailing address
920 DIANA ST, LUDINGTON, MI 49431-1987
(231) 845-6294
(231) 845-7095
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704342180
MI
Other
Enumeration date
03/27/2019
Last updated
03/27/2019
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