Individual
MRS. KIRSTEN MARIE PODVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
172 DOURDAN, BLOOMFIELD HILLS, MI 48304-1737
(248) 495-1764
Mailing address
172 DOURDAN, BLOOMFIELD HILLS, MI 48304-1737
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
06201513
MI
363LP2300X
Primary Care Nurse Practitioner
Primary
4704328121
MI
Other
Enumeration date
09/08/2020
Last updated
03/16/2021
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