# VENVISOR HEALTH MICHIGAN LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528695624
- **Authorized official:** JACKI MALDEN (VP OF REGIONAL OPERATIONS)
- **Authorized official phone:** (203) 567-5243

## Contact information

- **Practice address:** 400 RENAISSANCE CTR STE 200, DETROIT, MI 48243-1502
- **Practice address phone:** (203) 567-5243
- **Mailing address:** PO BOX 2533, SHELTON, CT 06484-8533
- **Mailing address phone:** (203) 567-5243

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 03/26/2020
- **Last updated:** 10/15/2021