Provider Demographics
NPI:1598858292
Name:GENTZ, STEVEN MICHAEL (RN MS CS)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:MICHAEL
Last Name:GENTZ
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Gender:M
Credentials:RN MS CS
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Mailing Address - Street 1:4122 SYLVAN RD.
Mailing Address - Street 2:
Mailing Address - City:GRASS LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49240
Mailing Address - Country:US
Mailing Address - Phone:734-769-7100
Mailing Address - Fax:734-769-7416
Practice Address - Street 1:2215 FULLER RD.
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105
Practice Address - Country:US
Practice Address - Phone:734-845-3041
Practice Address - Fax:734-222-7648
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2016-12-15
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Provider Licenses
StateLicense IDTaxonomies
MI4704170054163WP0808X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health