Kettlewell, Phyllis Ann
Kettlewell, Phyllis Ann is an individual health care provider with primary practice located at 740 N Macomb St , Monroe MI 48161. 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. Kettlewell, Phyllis Ann can be contacted via phone (734) 240-5238.Contact Information
Primary practice address
740 N Macomb St
Monroe MI 48161
Phone: (734) 240-5238
Fax: (734) 240-5273
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 4704133662 | Michigan |
Profile Details
| NPI number | 1568557957 |
|---|---|
| LBN Legal business name | Kettlewell, Phyllis Ann |
| Credentials | Certified Registered Nurse Anesthetist (CRNA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 3rd, 2006 |
| Last updated | Oct 10th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568557957 | NPPES |
| Michigan | MEDICAID | 4554473 |
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