Individual
KACEY LEE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
445 W MICHIGAN AVE, KALAMAZOO, MI 49007-3750
(269) 488-5460
Mailing address
2132 S BURDICK ST, KALAMAZOO, MI 49001-6125
(843) 817-0374
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704302741
MI
Other
Enumeration date
03/18/2018
Last updated
03/18/2018
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