Individual
KATHY FENTON-MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., A.N.P.-C
Contact information
Practice address
13320 N BOULEVARD ST, VICKSBURG, MI 49097-1514
(269) 649-2012
(269) 649-3318
Mailing address
13320 N BOULEVARD ST, VICKSBURG, MI 49097-1514
(269) 649-2012
(269) 649-3318
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
KF230686
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558572107
—
MI
Enumeration date
05/25/2007
Last updated
11/27/2023
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