Individual
MISS KELLIE MARIE LIEBAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
15847 SABRE, FRASER, MI 48026-2742
(586) 872-4328
Mailing address
15847 SABRE, FRASER, MI 48026-2742
(586) 872-4328
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704376334
MI
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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