Provider Demographics
NPI:1609162957
Name:VANSTEE, KALI CORINNE (PA-C)
Entity Type:Individual
Prefix:
First Name:KALI
Middle Name:CORINNE
Last Name:VANSTEE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KALI
Other - Middle Name:
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:302 HOBART ST
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-2379
Mailing Address - Country:US
Mailing Address - Phone:231-876-2644
Mailing Address - Fax:
Practice Address - Street 1:302 HOBART ST
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-2379
Practice Address - Country:US
Practice Address - Phone:231-876-2644
Practice Address - Fax:231-876-5106
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601006147363A00000X
OHNP-06940363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant