Provider Demographics
NPI:1235977802
Name:KESINOVIC, ILHANA (MSN, APRN FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ILHANA
Middle Name:
Last Name:KESINOVIC
Suffix:
Gender:F
Credentials:MSN, APRN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 HUPP CROSS RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD VILLAGE
Mailing Address - State:MI
Mailing Address - Zip Code:48301-2432
Mailing Address - Country:US
Mailing Address - Phone:586-864-0363
Mailing Address - Fax:
Practice Address - Street 1:516 HUPP CROSS RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD VILLAGE
Practice Address - State:MI
Practice Address - Zip Code:48301-2432
Practice Address - Country:US
Practice Address - Phone:586-864-0363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704327910363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily