| NPI | 1700831500 |
|---|---|
| Other Name | ST JOHN HOSPITAL NURSE PRACTITIONER |
| Entity Type | Organization |
| Authorized Contact | KIMBERLY CEBALT Manager Provider Affairs 313-874-6764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2025-11-14 |