Individual
KRISTIN MICHELLE KENNAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
1557 CRIMSON DR, TROY, MI 48083-5506
(248) 379-1863
Mailing address
1557 CRIMSON DR, TROY, MI 48083-5506
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
4704230867
MI
363L00000X
Nurse Practitioner
Primary
4704230867NSA190N6
MI
Other
Enumeration date
04/18/2019
Last updated
08/05/2019
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