Individual
ANN MARIE KUYKENDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
5777 W MAPLE RD STE 200, WEST BLOOMFIELD, MI 48322-2271
(248) 932-9223
(248) 932-8641
Mailing address
5777 W MAPLE RD STE 200, WEST BLOOMFIELD, MI 48322-2271
(248) 932-9223
(248) 932-8641
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601002554
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601002554
STATE LICENSE
MI
Enumeration date
03/10/2010
Last updated
03/10/2010
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