Healthcare Provider Details

I. General information

NPI: 1245075803
Provider Name (Legal Business Name): KRISTEN SCHELL PHOTOGRAPHY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2024
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 S WEST AVE
JACKSON MI
49203-1667
US

IV. Provider business mailing address

156 W MICHIGAN AVE UNIT 295
JACKSON MI
49201-1302
US

V. Phone/Fax

Practice location:
  • Phone: 724-884-5310
  • Fax:
Mailing address:
  • Phone: 724-884-5310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: KRISTEN SCHELL
Title or Position: OWNER
Credential:
Phone: 724-884-5310