Most Relevant Information
Provider Data
| NPI Number: | 1003218496 |
| Provider Name: | KYLE KRUPA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 4704276038 |
Most Important Dates
| Enumeration Date: | 09/17/2014 |
| Last Updated: | 01/29/2024 |
Provider Practice Location
2799 W GRAND BLVD
DETROIT
MI
482022608
Practice Location Phone/Fax
| Phone: | 3139162600 |
| Fax: |
Provider Mailing Location
1 FORD PL STE 3A
DETROIT
MI
482023450
Provider Mailing Phone/Fax
| Phone: | 3138744806 |
| Fax: |