Individual
SKYLER RAE DEWITT-COON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3900 KRESGE WAY, LOUISVILLE, KY 40207-4660
(502) 893-7710
Mailing address
3900 KRESGE WAY, LOUISVILLE, KY 40207-4660
(502) 893-7710
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601008792
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601008792
MICHIGAN PHYSICIAN ASSISTANT LICENSE
MI
Enumeration date
10/23/2018
Last updated
01/26/2024
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