| NPI | 1174931257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER KELSEY Operations Manager 810-733-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704254474) |
| Enumeration Date | 2014-08-01 |
| Last Update Date | 2023-10-30 |