Healthcare Provider Details

I. General information

NPI: 1144939570
Provider Name (Legal Business Name): VICKI LYNN KIEHL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2022
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 E SANILAC RD
SANDUSKY MI
48471-1160
US

IV. Provider business mailing address

227 E SANILAC RD
SANDUSKY MI
48471-1160
US

V. Phone/Fax

Practice location:
  • Phone: 810-648-0330
  • Fax:
Mailing address:
  • Phone: 810-648-0330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: