Individual
STEPHEN MICHAEL KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, CRNA
Contact information
Practice address
1500 E MEDICAL CENTER DR, 1H247 UNIVERSITY HOSPITAL, ANN ARBOR, MI 48109-5048
(734) 936-4280
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
4704269745
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704269745
MI
Other
Enumeration date
08/11/2017
Last updated
12/21/2018
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