Individual
SUSAN HELEN MCKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3601 W 13 MILE RD, FSC, ROYAL OAK, MI 48073-6712
(248) 423-2405
(248) 423-2576
Mailing address
3601 W 13 MILE RD, FSC, ROYAL OAK, MI 48073-6712
(248) 423-2454
(248) 423-2576
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704143131
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4726040
—
MI
01
—
500F318190
BSBSM
MI
Enumeration date
07/31/2006
Last updated
12/12/2008
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