Individual
DIANE MARIE KYKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(248) 343-4766
Mailing address
4920 RANDS RD, BLOOMFIELD HILLS, MI 48302-2260
(248) 737-0533
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704136312
MI
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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