Individual
MR. KENNETH ANDREW WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1215 E MICHIGAN AVE, LANSING, MI 48912-1811
(517) 364-3350
(517) 364-3943
Mailing address
PO BOX 13008, LANSING, MI 48901-3008
(517) 364-3350
(517) 364-3943
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704225787
MI
Other
Enumeration date
10/20/2009
Last updated
10/20/2009
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