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Individual

KRISTEN MIX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP, AGACNP

Contact information

Practice address
15855 19 MILE RD, CLINTON TOWNSHIP, MI 48038-3504
(586) 263-2300
Mailing address
950 SHERRY DR, LAKE ORION, MI 48362-2870

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
4704285817
MI
363LA2100X
Acute Care Nurse Practitioner
Primary
4704285817
MI

Other

Enumeration date
11/13/2020
Last updated
07/15/2022
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