Provider Demographics
NPI:1992293567
Name:DREW, KATHLEEN (RN)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:DREW
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8450 BERWICK DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-3853
Mailing Address - Country:US
Mailing Address - Phone:313-414-6531
Mailing Address - Fax:
Practice Address - Street 1:24755 5 MILE RD STE 202
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-3666
Practice Address - Country:US
Practice Address - Phone:313-414-6531
Practice Address - Fax:866-611-8861
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-28
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704305862163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management