Individual provider · Type 1 NPI

Kelly Rose Mikail, PA-C

Medical Physician Assistant · Grand Rapids, MI

NPI number 1497075766 Active

Practice location

4100 Lake Dr SE, Suite 200
Grand Rapids, MI 49546-8292

Call (616) 267-7293 Map

Fax (616) 267-7228

Mailing address

100 Michigan St NE, MC845
Grand Rapids, MI 49503-2560

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X5601005774 (MI)

Medical Physician Assistant: Definition to come...

159 other providers at this address

Other medical physician assistant providers in Grand Rapids

See all in Grand Rapids →

About NPI 1497075766

Kelly Rose Mikail, PA-C's National Provider Identifier is 1497075766, issued on Jun 9, 2010. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Grand Rapids, MI. The record was last updated on Feb 18, 2021.