location
search-icon
person
Kellie Distefano, PA-C
Physician Assistant in Hartford, Michigan
NPI 1386609543

Kellie Distefano is a Physician Assistant based in Watervliet, MI. Kellie Distefano practices in Hartford, MI and has the professional credentials of PA-C. The NPI Number for Kellie Distefano is 1386609543 and holds a License No. 5601002464 (Michigan).

The current practice location address for Kellie Distefano is 525 S Center St, Hartford, MI and can be reached out via phone at 269-621-4063 and via fax at 269-621-9972.

Location: 525 S Center St, Hartford, MI, 49098-9225
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1386609543
Provider Name
Kellie Distefano
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
525 S Center St, Hartford, MI, 49098-9225
Phone Number
269-621-4063
Fax Number
269-621-9972
Provider Enumeration Date
04/19/2006
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
06116A 01 MI BHP PROVIDER ID #
381368745126 01 MI CCM BILLING # FOR PA-C
101465 01 MI GLHP PIN #
KD002464 01 MI BCBS PROVIDER ID #
KD09184 01 MI HPM PROVIDER ID #
institution
Provider Business Practice Location Address Details
Address
525 S Center St
City
Hartford
State
Michigan
Zip
49057-1362
Phone Number
269-621-4063
Fax Number
269-621-9972
person
Provider Business Mailing Address Details
Address
525 S Center St
City
Hartford
State
Michigan
Zip
49057-1362
Phone Number
269-621-4063
Fax Number
269-621-9972
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
5601002464 (Michigan)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
-
Taxonomy
363A00000X
License No.
5601002464 (Michigan)
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
semi-verified symbol
Badge

Use the following badge on your website to showcase your NPI number and verified status. In a field with over 8 million healthcare providers in the United States, it is important to establish your identity clearly. Displaying this badge signifies that your information is both accurate and up-to-date.