Individual
ANNA KILLEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
588 E LAKEWOOD BLVD, 2ND FLOOR, HOLLAND, MI 49424-2023
(616) 494-5810
(616) 494-5901
Mailing address
100 MICHIGAN ST NE, MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6557
(616) 486-6702
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004321
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922283993
—
MI
Enumeration date
01/08/2008
Last updated
12/04/2020
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