Healthcare Provider Details

I. General information

NPI: 1568380475
Provider Name (Legal Business Name): KA WELLNESS PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3343 SPRING ARBOR RD STE 300
JACKSON MI
49203-8623
US

IV. Provider business mailing address

3343 SPRING ARBOR RD STE 300
JACKSON MI
49203-8623
US

V. Phone/Fax

Practice location:
  • Phone: 517-748-7399
  • Fax:
Mailing address:
  • Phone: 517-748-7399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KRISTEN YOKLEY
Title or Position: NP
Credential:
Phone: 517-888-1300