Individual
KATELYN KHEMMORO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11012 E 13 MILE RD STE 112, WARREN, MI 48093-2546
(586) 573-6880
Mailing address
6376 TIMBERWOOD S, WEST BLOOMFIELD, MI 48322-2007
(248) 513-1883
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601012088
MI
363AM0700X
Medical Physician Assistant
Primary
5601012088
MI
Other
Enumeration date
10/11/2023
Last updated
02/20/2026
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