Provider Demographics
NPI:1366791097
Name:PYLES, KELLI DENISE (PA)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:DENISE
Last Name:PYLES
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:1 HURLEY PLZ
Mailing Address - Street 2:SON, 5TH FLOOR
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-5902
Mailing Address - Country:US
Mailing Address - Phone:810-262-9353
Mailing Address - Fax:810-760-0440
Practice Address - Street 1:1 HURLEY PLZ
Practice Address - Street 2:EMERGENCY DEPT.
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-5902
Practice Address - Country:US
Practice Address - Phone:810-262-9429
Practice Address - Fax:810-262-9104
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-10
Last Update Date:2023-06-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5601006468363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant