| NPI | 1427171511 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | KATHY STEVENS Billing Coordinator 248-327-1586  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 630070)  | 
| Enumeration Date | 2007-04-06 | 
| Last Update Date | 2020-11-18 |