| Doctor Name: | KRISTIN KENTROS |
| NPI Number: | 1043630965 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | 4704277986 |
| Business Practice Address: | 8338 Vanden Dr White Lake, MI - 483862552 |
| Business Phone Number: | 2488850502 |
| Business Fax Number: | |
| Mailing Address: | 8338 Vanden Dr, WHITE LAKE |
| State: | MI |
| Postal Code: | 483862552 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/17/2014 |
| NPI Last Update Date: | 04/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC0400X |
| License Number: | 4704277986 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Case Management |
| Taxonomy Definition: | |