Provider Demographics
NPI:1932201167
Name:SAINT JOSEPH MERCY HOSPITAL
Entity Type:Organization
Organization Name:SAINT JOSEPH MERCY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:MADELINE
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:810-225-0197
Mailing Address - Street 1:4574 WINDSWEPT DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48380-2776
Mailing Address - Country:US
Mailing Address - Phone:810-225-0197
Mailing Address - Fax:
Practice Address - Street 1:5361 MCAULEY DRIVE
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48106-0995
Practice Address - Country:US
Practice Address - Phone:734-712-0654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704163853363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty