Type | Person | [sources] | |||
---|---|---|---|---|---|
Name | Kellie Distefano | [sources] | |||
Birth date | not available | [sources] | |||
Nationality | not available | [sources] | |||
Country | United States of America | [sources] | |||
First name | Kellie | [sources] | |||
Last name | Distefano | [sources] | |||
NPI | 1386609543 | [sources] | |||
Sector | Physician Assistant | [sources] | |||
Address | Saugatuck, MI | [sources] | |||
Last change | Last processed | First seen |
Providers who have been terminated for cause from Michigan's Medicaid program.
United States of America · MDHHS
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