Individual
MISS KELLY PHUONG DOAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
33021 GARFIELD RD, FRASER, MI 48026-1800
(586) 293-5012
Mailing address
33021 GARFIELD RD, FRASER, MI 48026-1800
(586) 293-5012
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704335421
MI
Other
Enumeration date
11/04/2020
Last updated
05/24/2021
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