Kislov, Carmen G

Kislov, Carmen G is an individual health care provider with primary practice located at 33155 Annapolis St , Wayne MI 48184-2405. 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. Kislov, Carmen G can be contacted via phone (734) 467-4667.

Contact Information

Primary practice address
33155 Annapolis St Wayne MI 48184-2405
Phone: (734) 467-4667
Fax: (734) 467-2303
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 4704210733 Michigan

Profile Details

NPI number 1063599876
LBN Legal business name Kislov, Carmen G
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Jul 8th, 2007 - about 17 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 1063599876 NPPES
Michigan MEDICAID 4328730

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