Individual
KYLE ROBERT KINNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 JOHN ST, SUITE M-401, KALAMAZOO, MI 49007-5341
(269) 341-8855
(269) 341-8743
Mailing address
601 JOHN ST, SUITE M-401, KALAMAZOO, MI 49007-5341
(269) 349-7696
(269) 488-8313
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601006110
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8650800300
BCBS
MI
Enumeration date
08/26/2011
Last updated
10/16/2014
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