Individual
KELVIN DEWAYNE RODEN-SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2333 BIDDLE AVE, WYANDOTTE, MI 48192-4668
(734) 246-6000
Mailing address
1640 FORT ST, SUITE D ATTN DENISE, TRENTON, MI 48183-2040
(734) 391-3057
(734) 391-3052
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704226230
MI
363LA2100X
Acute Care Nurse Practitioner
Primary
4704226230
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
BLUE CROSS
—
Enumeration date
03/11/2009
Last updated
05/01/2025
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