Cantillon, Kimberly T

Cantillon, Kimberly T is an individual health care provider with primary practice located at 39450 W 12 Mile Rd , Novi MI 48377-3600. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Cantillon, Kimberly T can be contacted via phone (313) 461-4632.

Contact Information

Primary practice address
39450 W 12 Mile Rd Novi MI 48377-3600
Phone: (313) 461-4632
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 5601004760 Michigan

Profile Details

NPI number 1740218999
LBN Legal business name Cantillon, Kimberly T
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2006
Last updated Jan 28th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740218999 NPPES
Michigan Other 5301004760 LICENSE

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