Individual
KELLY JAYNE MCCARTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1911 VIKING CIR, COMMERCE TOWNSHIP, MI 48390-1579
(248) 719-5889
Mailing address
1911 VIKING CIR, COMMERCE TOWNSHIP, MI 48390-1579
(248) 719-5889
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704303843
MI
363LF0000X
Family Nurse Practitioner
Primary
4704303843
MI
Other
Enumeration date
04/11/2018
Last updated
05/05/2026
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