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NPI Code Detail

MEDICARE: KELLY ESTELL

MEDICARE: KELLY ESTELL
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
1163WP0808XPsychiatric/Mental Health Registered Nurse4704365432MI

General Provider Information

NPI Number : 1407781222
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY ESTELL
Provider Business Mailing Address
First Line : 34290 FORD RD
Second Line :
City : WESTLAND
State : MI
Zip : 48185-3051
Country : US
Telephone Number : 734-412-8800
Fax Number :
Provider Business Practice Location Address
First Line : 34290 FORD RD
Second Line :
City : WESTLAND
State : MI
Zip : 48185-3051
Country : US
Telephone Number : 734-412-8800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2026
Last Update Date : 06/15/2026

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Directions to “ KELLY ESTELL ” Practice Location

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