Healthcare Provider Details

I. General information

NPI: 1689314551
Provider Name (Legal Business Name): JASLYN LARAE KINDEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JASLYN LARAE MORRIS

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3305 SPRING ARBOR RD STE 500
JACKSON MI
49203-3795
US

IV. Provider business mailing address

1 FORD PL STE 3A
DETROIT MI
48202-3450
US

V. Phone/Fax

Practice location:
  • Phone: 517-205-3187
  • Fax:
Mailing address:
  • Phone: 800-436-7936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number682
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301516948
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: