# W.A. FOOTE MEMORIAL HOSPITAL, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ALLEGIANCE HEALTH SERVICES
- **Other names:** Henry Ford Allegiance Health
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1366988347
- **Legal business name:** ALLEGIANCE HEALTH SERVICES
- **Authorized official:** MARK SMITH (SVP, CMO, CEO)
- **Authorized official phone:** (517) 205-6407

## Contact information

- **Practice address:** 205 N. EAST AVE, JACKSON, MI 49201
- **Practice address phone:** (517) 205-7843
- **Mailing address:** PO BOX 67000, DEPARTMENT 272801, DETROIT, MI 48267-2728
- **Mailing address phone:** (517) 205-7843
- **Mailing address fax:** (517) 841-7419

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 1060000044 | MI | Yes |
| 363LA2100X | Acute Care Nurse Practitioner | — | NULL | — |
| 363LA2100X | Acute Care Nurse Practitioner | — | — | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | NULL | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | — | — |
| 363LP0200X | Pediatric Nurse Practitioner | — | NULL | — |
| 363LP0200X | Pediatric Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |
| 363LW0102X | Women's Health Nurse Practitioner | — | NULL | — |
| 363LW0102X | Women's Health Nurse Practitioner | — | — | — |
| 367A00000X | Advanced Practice Midwife | — | NULL | — |
| 367A00000X | Advanced Practice Midwife | — | — | — |

## Other

- **Enumeration date:** 01/13/2017
- **Last updated:** 07/29/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1629000708 | — | MI |