Physician Assistant, Medical
KELLY BANNASCH PA-C
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1043330889 · enumerated 2007-03-29 · record updated 2012-01-24. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Addresses and phones
- Mailing address 6071 W OUTER DR, DETROIT, MI, 48235-2624 (313) 966-8559 Google Maps Apple Maps OpenStreetMap
- Practice location 6071 W OUTER DR, DETROIT, MI, 48235-2624 (313) 966-8559 Google Maps Apple Maps OpenStreetMap
Specialties
- Physician Assistant, Medical 363AM0700X · Primary · License 5601002420 MI
In this directory
Locations and evidence
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Practice location
DETROIT, MI, 482352624
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.