Provider Demographics
NPI:1154303865
Name:KAHN, MARIAN BLAESSER (FNP)
Entity Type:Individual
Prefix:DR
First Name:MARIAN
Middle Name:BLAESSER
Last Name:KAHN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 CROOKS RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-3300
Mailing Address - Country:US
Mailing Address - Phone:248-721-9878
Mailing Address - Fax:
Practice Address - Street 1:2530 CROOKS RD
Practice Address - Street 2:STE 3
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-3300
Practice Address - Country:US
Practice Address - Phone:248-721-9878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN 164653 NP363LF0000X
MI4704186755363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily