| NPI | 1639253784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA RUCKER Enrollment & Patient Accts Manager 517-884-2976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 207RR0500X Internal Medicine, Rheumatology | |
| 363A00000X Physician Assistant | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| 363LW0102X Nurse Practitioner, Women's Health | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2018-04-05 |