Individual
KIM CECCANESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
135 BARCLAY CIR, SUITE 104, ROCHESTER HILLS, MI 48307-4599
(248) 853-7270
(248) 853-7230
Mailing address
PO BOX 1108, ATTENTION: LYNDA THOMPSON, ANN ARBOR, MI 48106-1108
(734) 677-7400
(734) 677-7407
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704150130
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4292496
—
MI
01
—
5008666430
BCBS
MI
Enumeration date
08/24/2006
Last updated
07/08/2007
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