Provider Demographics
NPI:1427552587
Name:TEMPLE, KAILEY ALLISON (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KAILEY
Middle Name:ALLISON
Last Name:TEMPLE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 HIGHLAND RD STE D
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-2162
Mailing Address - Country:US
Mailing Address - Phone:248-682-3070
Mailing Address - Fax:248-682-3626
Practice Address - Street 1:3901 HIGHLAND RD STE D
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-2162
Practice Address - Country:US
Practice Address - Phone:248-682-3070
Practice Address - Fax:248-682-3626
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704289808363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily