Individual
MRS. KELLIE RENEE DONASTORG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1113 HUNTERS RUN DR, GRAND BLANC, MI 48439-6301
(810) 656-3004
(810) 656-3004
Mailing address
1113 HUNTERS RUN DR, GRAND BLANC, MI 48439-6301
(810) 656-3004
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704230071
MI
Other
Enumeration date
06/21/2017
Last updated
06/21/2017
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