Provider Demographics
NPI:1538220470
Name:KAMINSKI, PATRICIA A (CNP)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
Last Name:KAMINSKI
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:A
Other - Last Name:LONGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:2799 W GRAND BLVD
Mailing Address - Street 2:DEPARTMENT OF NEUROSURGERY
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-2608
Mailing Address - Country:US
Mailing Address - Phone:313-916-1340
Mailing Address - Fax:
Practice Address - Street 1:2799 W GRAND BLVD
Practice Address - Street 2:DEPARTMENT OF NEUROSURGERY
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-1340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704193603363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner