Organization Name: | WOMEN'S INTEGRATED HEALTH CARE |
NPI Number: | 1063767655 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DIANA L RUSHLOW (PRACTICE MANAGER) |
Mailing Address: | 1595 Genesys Pkwy Grand Blanc |
State: | MI US |
Postal Code: | 484398068 |
Phone Number: | 8106067739 |
Fax Number: | 8106069400 |
NPI Enumeration Date: | 07/19/2012 |
NPI Last Update Date: | 07/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LX0001X |
License Number: | 4704155625 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Obstetrics & Gynecology |
Taxonomy Definition: |