Healthcare Provider Details

I. General information

NPI: 1275468266
Provider Name (Legal Business Name): ALLISON MICHELLE KITCHEN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9468 S SAGINAW RD
GRAND BLANC MI
48439-9668
US

IV. Provider business mailing address

1980 WORCESTER DR
OXFORD MI
48371-5922
US

V. Phone/Fax

Practice location:
  • Phone: 810-498-2042
  • Fax:
Mailing address:
  • Phone: 231-622-2967
  • Fax: 231-622-2967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704329506
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: