Individual
JACQUELINE KIROUAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, AGNP-C, APRN
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-3000
Mailing address
1848 CARSONS CV, COMMERCE TOWNSHIP, MI 48390-1865
(248) 881-4287
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
4704341154
MI
363LP2300X
Primary Care Nurse Practitioner
Primary
AG11210087
MI
Other
Enumeration date
02/12/2024
Last updated
02/12/2024
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