Individual
KYLE MARIE CAMERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA, MS
Contact information
Practice address
4100 PARK FOREST DR, SUTIE210, TRAVERSE CITY, MI 49684-7331
(231) 935-5770
(231) 935-0747
Mailing address
4100 PARK FOREST DR, SUTIE210, TRAVERSE CITY, MI 49684-7331
(231) 935-5770
(231) 935-0747
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704276317
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992103212
—
MI
Enumeration date
12/18/2014
Last updated
08/12/2016
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