Potochny, Kelly M

Potochny, Kelly M is an individual health care provider with primary practice located at 401 S Ballenger Hwy Attn Surgical Services, Flint MI 48532-3638. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Potochny, Kelly M can be contacted via phone (810) 342-4917.

Contact Information

Primary practice address
401 S Ballenger Hwy Attn Surgical Services Flint MI 48532-3638
Phone: (810) 342-4917
Fax: (810) 342-1335
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601003490 Michigan

Profile Details

NPI number 1154390706
LBN Legal business name Potochny, Kelly M
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2006
Last updated Oct 9th, 2012 - about 12 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 1154390706 NPPES
Michigan Other P00000563 TRAVELERS

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