Provider Demographics
NPI:1619929460
Name:MICHIGAN VISITING NURSE CORPORATION
Entity Type:Organization
Organization Name:MICHIGAN VISITING NURSE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-975-3095
Mailing Address - Street 1:2850 S INDUSTRIAL HWY
Mailing Address - Street 2:SUITE 75A
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-6796
Mailing Address - Country:US
Mailing Address - Phone:734-677-4515
Mailing Address - Fax:
Practice Address - Street 1:2850 S INDUSTRIAL HWY
Practice Address - Street 2:SUITE 75A
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-6796
Practice Address - Country:US
Practice Address - Phone:734-677-4515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health