# BOTSFORD GENERAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BOTSFORD GENERAL HOSPITAL
- **Other names:** Comprehensive OBGYN NP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1104144500
- **Legal business name:** BOTSFORD GENERAL HOSPITAL
- **Authorized official:** LESLEY WILLBRANDT (DIRECTOR SHARED SERVICES)
- **Authorized official phone:** (947) 522-1911

## Contact information

- **Practice address:** 28711 8 MILE RD, STE C, LIVONIA, MI 48152-2040
- **Practice address phone:** (248) 474-4590
- **Mailing address:** 26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LX0001X | Obstetrics & Gynecology Nurse Practitioner | — | NULL | Yes |
| 363LX0001X | Obstetrics & Gynecology Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/10/2010
- **Last updated:** 08/16/2019