# BOTSFORD GENERAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BOTSFORD NURSE PRACTITIONER
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1013468198
- **Legal business name:** BOTSFORD NURSE PRACTITIONER
- **Authorized official:** LESLEY WILLBRANDT (DIRECTOR SHARED SERVICES)
- **Authorized official phone:** (947) 522-1911

## Contact information

- **Practice address:** 28050 GRAND RIVER AVE, FARMINGTON HILLS, MI 48336-5919
- **Practice address phone:** (248) 471-8147
- **Mailing address:** 26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 1060000070 | MI | Yes |

## Other

- **Enumeration date:** 10/24/2016
- **Last updated:** 08/21/2019