Individual
KELLY SHAFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2115 25 MILE RD, SHELBY TOWNSHIP, MI 48316-1097
(866) 389-2727
Mailing address
26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704272276
MI
Other
Enumeration date
09/17/2015
Last updated
05/18/2022
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