Martin, Kellie

Martin, Kellie is an individual health care provider with primary practice located at 22101 Moross , Detroit MI 48226. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Martin, Kellie can be contacted via phone (313) 343-4766.

Contact Information

Primary practice address
22101 Moross Detroit MI 48226
Phone: (313) 343-4766
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 4704173942 Michigan

Profile Details

NPI number 1629032636
LBN Legal business name Martin, Kellie
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2006
Last updated Jul 8th, 2007 - about 19 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 1629032636 NPPES
Michigan Other KM173942 BLUE CROSS OF MI

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