Carole Kavanaugh
Registered Nurse in Novi, MI. Individual provider (NPI-1).
NPI number1164099891
StatusActive
Last updated in NPPESJun 10, 2021
Details
- NPI
- 1164099891
- Entity type
- Individual (NPI-1)
- Name
- Carole Kavanaugh
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 10, 2021
- Certification date
- Jun 10, 2021
- Last updated
- Jun 10, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 4704285697 | MI | Yes |
Practice location
41795 W 12 Mile RdNovi, MI 48377-3107
Phone 249-449-1655
Mailing address
41795 W 12 Mile RdNovi, MI 48377-3107
Phone 249-449-1655
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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