Individual
KAITLYN CLARK GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
41011 N MAPLEWOOD DR, CANTON, MI 48187-3976
(832) 483-3668
Mailing address
41011 N MAPLEWOOD DR, CANTON, MI 48187-3976
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704391152
MI
363LF0000X
Family Nurse Practitioner
Primary
4704391152
MI
363LP2300X
Primary Care Nurse Practitioner
4704391152
MI
Other
Enumeration date
08/31/2024
Last updated
08/31/2024
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