Kellie Distefano, PA-C
Kellie Distefano, PA-C is a Family Medicine Physician in Hartford, Michigan. Licensed in Michigan. Registered with an NPI since 2006.
- Licensed in
- MI
- In the registry since
- 2006
- Specialties on file
- 2
What do these letters mean?
- PA-C — Physician Assistant, Certified
- A physician assistant who holds current national certification.
Practice location Address checks out
525 S Center StHartford, MI 49057-1362
Phone: (269) 621-4063
Fax: (269) 621-9972
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Family Medicine Physician (primary) | Taxonomy 207Q00000X · Licence 5601002464 (MI) |
|---|---|
| Physician Assistant | Taxonomy 363A00000X · Licence 5601002464 (MI) |
Record details
| NPI number | 1386609543 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | PA-C |
| Sole proprietor | No |
| NPI enumerated | April 19, 2006 |
| Last updated in NPPES | December 18, 2007 |
| Mailing address | 400 Medical Park Dr, Watervliet, MI 49098-9225 |
Other providers in Hartford
-
Lakeland Community Hospital Watervliet
525 S Center St, Hartford, MI 49057-1362 · (269) 621-4063
-
Jay Shah, MD
525 S Center St, Hartford, MI 49057-1362 · (269) 463-3600