Provider Demographics
NPI:1538987540
Name:CIANFARANI, KAISSA LYNN-MOON
Entity type:Individual
Prefix:
First Name:KAISSA
Middle Name:LYNN-MOON
Last Name:CIANFARANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAISSA
Other - Middle Name:
Other - Last Name:MOON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1737 W WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48208-2214
Mailing Address - Country:US
Mailing Address - Phone:734-478-2859
Mailing Address - Fax:
Practice Address - Street 1:1500 E MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5000
Practice Address - Country:US
Practice Address - Phone:734-478-2859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula