Doctor Name: | MRS. KELLEY MARIE SZUMA |
NPI Number: | 1043614753 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | 4704266878 |
Business Practice Address: | 39350 9 Mile Rd Northville, MI - 481679164 |
Business Phone Number: | 2487356081 |
Business Fax Number: | |
Mailing Address: | 39350 Nine Mile Road, NORTHVILLE |
State: | MI |
Postal Code: | 48167 |
Phone Number: | 2487356081 |
Fax Number: | |
NPI Enumeration Date: | 10/09/2014 |
NPI Last Update Date: | 10/09/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 4704266878 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |