Provider Demographics
NPI:1992271985
Name:KINDERMANN, JEAN MARIE (NP)
Entity type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:MARIE
Last Name:KINDERMANN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:414 UNION ST
Mailing Address - Street 2:STE 100
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381
Mailing Address - Country:US
Mailing Address - Phone:248-676-8889
Mailing Address - Fax:248-685-8039
Practice Address - Street 1:414 UNION ST
Practice Address - Street 2:STE 100
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381
Practice Address - Country:US
Practice Address - Phone:248-676-8889
Practice Address - Fax:248-685-8039
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704206667363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner