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Individual

MRS. KENDRA ANN CALHOUN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ACNP

Contact information

Practice address
5450 FORT ST, TRENTON, MI 48183-4601
(734) 642-2132
Mailing address
1819 3RD ST, WYANDOTTE, MI 48192-4001
(734) 285-5758

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
4704232995
MI
363LA2100X
Acute Care Nurse Practitioner
Primary
4704232995
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4704232995
MICHIGAN NURSE PRACTITIONER SPECIALTY LICENSE
MI
Enumeration date
09/25/2012
Last updated
01/20/2016
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