Provider Demographics
NPI:1346056892
Name:TOLONEN, KAITLYNN DENISE (FNP-C)
Entity type:Individual
Prefix:
First Name:KAITLYNN
Middle Name:DENISE
Last Name:TOLONEN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 HAGGERTY RD STE 1010
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-2185
Mailing Address - Country:US
Mailing Address - Phone:248-926-9111
Mailing Address - Fax:
Practice Address - Street 1:700 ALLEN DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:MI
Practice Address - Zip Code:48357-3504
Practice Address - Country:US
Practice Address - Phone:248-330-6682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704373349363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily