Individual
MS. MARILYN CARMELA KETCHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CANP
Contact information
Practice address
2310 E MICHIGAN AVE, LANSING, MI 48912-4018
(517) 346-7628
(517) 346-7629
Mailing address
2310 E MICHIGAN AVE, LANSING, MI 48912-4018
(517) 346-7628
(517) 346-7629
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
4704149979
MI
Other
Enumeration date
02/16/2010
Last updated
02/16/2010
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