Kelly Ann Mann, MSN, FNP-BC, CDE

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704175148 Issued in MI

Practice address

3031 W Grand Blvd
Suite 800 Endo Metab
Detroit, MI 48202-3046

Phone

(313) 916-3906

Fax

(313) 916-3907

NPI assigned

Feb 15, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285545600000",
    "number": "1053454447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 W GRAND BLVD STE 800",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023141",
            "telephone_number": "313-916-3906",
            "fax_number": "313-916-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 W GRAND BLVD",
            "address_2": "SUITE 800 ENDO METAB",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023046",
            "telephone_number": "313-916-3906",
            "fax_number": "313-916-3907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MSN, FNP-BC, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2010-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "MI",
            "license": "4704175148",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704175148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Mann
• Amardeep K Mann, MD
• Carlotta Trenice Mann, LLMSW
• Jasmine Mann
• Kate Marie Mann, RD
• Lashawn Patrice Mann
• William Mann
• Yasmeen Kaur Mann
• Manna of Detroit
• Manna of Detroit Inc.

• Family Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.