Individual provider · Type 1 NPI
Keoviengkhone Merina Hakvongsa, NP
Family Nurse Practitioner · Detroit, MI
NPI number
1992804660
Active
Practice location
22201 Moross Rd, Suite 150
Detroit, MI 48236-2169
Fax (586) 532-6496
Mailing address
45640 Schoenherr Rd, Suite B
Shelby Township, MI 48315-6033
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 4704212195 (MI) |
Family Nurse Practitioner: Definition to come...
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About NPI 1992804660
Keoviengkhone Merina Hakvongsa, NP's National Provider Identifier is 1992804660, issued on Sep 21, 2006. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Detroit, MI. The record was last updated on Jan 8, 2015.