Provider Demographics
NPI:1154373090
Name:PAPIN, KAYLEEN P (MD)
Entity type:Individual
Prefix:DR
First Name:KAYLEEN
Middle Name:P
Last Name:PAPIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1401 PRESQUE ISLE AVENUE
Mailing Address - Street 2:HEALTH CENTER
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855
Mailing Address - Country:US
Mailing Address - Phone:906-227-2355
Mailing Address - Fax:906-227-2332
Practice Address - Street 1:1401 PRESQUE ISLE AVENUE
Practice Address - Street 2:HEALTH CENTER
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855
Practice Address - Country:US
Practice Address - Phone:906-227-2355
Practice Address - Fax:906-227-2332
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301097662207Q00000X, 207P00000X
WI45292207Q00000X
MI5315048052207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1154373090OtherCOMMERCIAL
WI34371400Medicaid
WI34371400Medicaid