Individual
MR. DOUGLAS CLAYTON KINNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ACNP
Contact information
Practice address
6777 W MAPLE RD, WEST BLOOMFIELD, MI 48322-3013
(248) 325-1000
Mailing address
11657 MORGAN AVE, PLYMOUTH, MI 48170-4438
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704271318
MI
Other
Enumeration date
08/22/2012
Last updated
08/22/2012
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