Search › Michigan › 207Q00000X
Kellie Distefano, PA-C
NPI 1386609543 · on the registry since 2006
Practice
- Address
- 525 S Center St
Hartford, MI 49057 - Phone
- (269) 621-4063
- Fax
- (269) 621-9972
- Organisation at this address
- Lakeland Community Hospital Watervliet
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 207Q00000X
207Q00000X
- Also registered as
- 363A00000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2007-12-18
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan