Healthcare Provider Details
I. General information
NPI: 1417625856
Provider Name (Legal Business Name): BRITTANY KERCHEN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/31/2021
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
205 N EAST AVE
JACKSON MI
49201-1753
US
IV. Provider business mailing address
1 FORD PL STE 3A
DETROIT MI
48202-3450
US
V. Phone/Fax
- Phone: 517-205-4800
- Fax:
- Phone: 313-874-4806
- Fax: 313-876-1305
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 5601013576 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | PA15063 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: