Provider Demographics
NPI:1952023947
Name:MCCLOSKEY, KYLIE RAE (PA-C)
Entity Type:Individual
Prefix:
First Name:KYLIE
Middle Name:RAE
Last Name:MCCLOSKEY
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Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:29735 ALEXANDRA LN
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-3493
Mailing Address - Country:US
Mailing Address - Phone:586-864-4166
Mailing Address - Fax:
Practice Address - Street 1:222 RACKHAM BUILDING
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197
Practice Address - Country:US
Practice Address - Phone:734-487-2843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant