Individual
KIM HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
159 KERCHEVAL AVE, GROSSE POINTE, MI 48236
(586) 569-1329
Mailing address
3107 PROMENADE CIR, ANN ARBOR, MI 48108-1559
(734) 276-8054
(952) 442-3630
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704222209
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104820177
—
MI
01
—
KC222209
BLUE CROSS OF MI
MI
Enumeration date
08/28/2006
Last updated
07/17/2018
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