MEDICARE: KAYLEE CHIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	F11250708	MI

General Provider Information

NPI Number	:	1326905274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLEE CHIN

Provider Business Mailing Address
First Line	:	907 STANLEY BLVD
Second Line	:
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-1672
Country	:	US
Telephone Number	:	248-515-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 S ADAMS RD STE 100
Second Line	:
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-7017
Country	:	US
Telephone Number	:	248-266-5733
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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Directions to “ KAYLEE CHIN ” Practice Location

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