Healthcare Provider Details

I. General information

NPI: 1780548701
Provider Name (Legal Business Name): MS. DEKOA KRISTINE KESSLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4111 W WACKERLY ST
MIDLAND MI
48640-2119
US

IV. Provider business mailing address

4111 W WACKERLY ST
MIDLAND MI
48640-2119
US

V. Phone/Fax

Practice location:
  • Phone: 989-750-8267
  • Fax:
Mailing address:
  • Phone: 989-750-8267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: