Provider Demographics
NPI:1578988192
Name:VISITING NURSE PRACTITIONERS OF MICHIGAN
Entity Type:Organization
Organization Name:VISITING NURSE PRACTITIONERS OF MICHIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:248-497-8361
Mailing Address - Street 1:28089 HICKORY DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-2954
Mailing Address - Country:US
Mailing Address - Phone:248-497-8361
Mailing Address - Fax:
Practice Address - Street 1:28089 HICKORY DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-2954
Practice Address - Country:US
Practice Address - Phone:248-497-8361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-19
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704210540363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty