Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 4704266692 | MI |
Y | 363LA2200X | Nurse Practitioner - Adult Health | 4704266692 | MI |
N | 363LG0600X | Nurse Practitioner - Gerontology | 4704266692 | MI |
NPI | 1073028130 |
---|---|
Provider Name | Renee Kinaia |
First Address | Sterling Heights, MI 48310-4842 |
Second Address | Sterling Heights, MI 48310-4842 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2017 |
Last Update Date | 09/11/2020 |