Individual
KELLY ANNE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
17330 NORTHLAND PARK CT, SOUTHFIELD, MI 48075-4318
(248) 552-9500
Mailing address
2135 STONINGTON LN, ROCHESTER HILLS, MI 48306-3164
(248) 550-6646
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704305869
MI
Other
Enumeration date
10/21/2024
Last updated
10/21/2024
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