Individual
MRS. CAITLIN MARIE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AG-ACNP
Contact information
Practice address
29001 HARPER AVE, SAINT CLAIR SHORES, MI 48081-2711
(586) 778-0664
(586) 778-0396
Mailing address
30025 CHAMPINE ST, SAINT CLAIR SHORES, MI 48082-1653
(586) 504-0296
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704299955
MI
Other
Enumeration date
11/08/2017
Last updated
04/23/2019
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