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General NPI Number Information
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NPI Number | 1063373348
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Entity Type | Individual
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Provider Name | MARY KIENITZ
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Gender | Female
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Dates
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Enumeration Date | 11/18/2025
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 144 W WHEATLAND AVE
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City | REMUS
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State | MI
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Zip | 49340-5115
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Country | US
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Telephone | 989-967-3360
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Fax | 989-967-3374
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Provider Business Mailing Address
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Address Line | 144 W WHEATLAND AVE
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City | REMUS
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State | MI
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Zip | 49340-5115
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Country | US
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Telephone | 989-967-3360
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Fax | 989-967-3374
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 5302027407
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License Number State | MI
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