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General NPI Number Information
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NPI Number | 1770670788
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Entity Type | Individual
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Provider Name | JESSICA A KILEY MD
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Gender | Female
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 04/15/2021
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Provider Practice Location Address
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Address Line | 1035 CHARLEVOIX DR STE 200
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City | GRAND LEDGE
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State | MI
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Zip | 48837-2223
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Country | US
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Telephone | 517-626-3100
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Fax | 517-626-3110
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Provider Business Mailing Address
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Address Line | 1035 CHARLEVOIX DR STE 200
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City | GRAND LEDGE
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State | MI
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Zip | 48837-2223
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Country | US
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Telephone | 517-626-3100
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Fax | 517-626-3110
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301088707
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4301088707
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License Number State | MI
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