Healthcare Provider Details

I. General information

NPI: 1659298339
Provider Name (Legal Business Name): SHOUA KUE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 E KEARSLEY ST ATTN: 4125 WSW BUILDING
FLINT MI
48502
US

IV. Provider business mailing address

8076 PENINSULA CIR
GRAND BLANC MI
48439-7263
US

V. Phone/Fax

Practice location:
  • Phone: 810-762-3147
  • Fax:
Mailing address:
  • Phone: 810-241-2057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4704378454
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: