Individual
MIRANDA KIZY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1770 FORT ST, LINCOLN PARK, MI 48146-1904
(313) 466-4000
Mailing address
4470 WOODRIDGE CT, WATERFORD, MI 48328-4276
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704317031
MI
Other
Enumeration date
12/15/2021
Last updated
12/15/2021
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