Healthcare Provider Details

I. General information

NPI: 1689420671
Provider Name (Legal Business Name): KIRAH HELEN SWEET PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIRAH HELEN OSENTOSKI PA-C

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 BUSCHLEN RD
BAD AXE MI
48413-9177
US

IV. Provider business mailing address

75 BUSCHLEN RD
BAD AXE MI
48413-9177
US

V. Phone/Fax

Practice location:
  • Phone: 989-623-9300
  • Fax: 989-269-0243
Mailing address:
  • Phone: 989-236-9300
  • Fax: 989-269-0243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601012482
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: