Doctor Name: | KARI MCAVOY |
NPI Number: | 1134540883 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | N.P. |
License Number: | 4704190187 |
Business Practice Address: | 1 William Carls Dr Suite 240 Commerce Township, MI - 483822201 |
Business Phone Number: | 2489373338 |
Business Fax Number: | |
Mailing Address: | 8200 Foster Rd, CLARKSTON |
State: | MI |
Postal Code: | 483461950 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/25/2013 |
NPI Last Update Date: | 12/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP2300X |
License Number: | 4704190187 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |