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NPI Code Detail

MEDICARE: KARI MCAVOY N.P.

MEDICARE: KARI MCAVOY N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP2300XPrimary Care Nurse Practitioner4704190187MI
2363LF0000XFamily Nurse Practitioner4704190187MI

General Provider Information

NPI Number : 1134540883
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARI MCAVOY N.P.
Provider Business Mailing Address
First Line : 100 W WEST MAPLE RD
Second Line :
City : WALLED LAKE
State : MI
Zip : 48390-3402
Country : US
Telephone Number : 866-389-2727
Fax Number :
Provider Business Practice Location Address
First Line : 100 W WEST MAPLE RD
Second Line :
City : WALLED LAKE
State : MI
Zip : 48390-3402
Country : US
Telephone Number : 866-389-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/25/2013
Last Update Date : 06/22/2020

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Directions to “ KARI MCAVOY N.P.” Practice Location

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