# HENRY FORD HEALTH SYSTEM

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

## Provider details

- **NPI number:** 1811073901
- **Authorized official:** SHANNON PHILLIPS (PROVIDER ENROLLMENT SPECIALIST)
- **Authorized official phone:** (313) 874-2892

## Contact information

- **Practice address:** 2799 W GRAND BLVD, DETROIT, MI 48202-2608
- **Practice address phone:** (313) 916-2600
- **Mailing address:** 2799 W GRAND BLVD, DETROIT, MI 48202-2608
- **Mailing address phone:** (313) 916-2600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 830190 | MI | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |
| 363AS0400X | Surgical Physician Assistant | — | NULL | — |
| 363AS0400X | Surgical Physician Assistant | — | — | — |
| 363LA2100X | Acute Care Nurse Practitioner | — | NULL | — |
| 363LA2100X | Acute Care Nurse Practitioner | — | — | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LC0200X | Critical Care Medicine Nurse Practitioner | — | NULL | — |
| 363LC0200X | Critical Care Medicine Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | NULL | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | — | — |
| 363LN0000X | Neonatal Nurse Practitioner | — | NULL | — |
| 363LN0000X | Neonatal Nurse Practitioner | — | — | — |
| 363LN0005X | Critical Care Neonatal Nurse Practitioner | — | NULL | — |
| 363LN0005X | Critical Care Neonatal Nurse Practitioner | — | — | — |
| 363LP0200X | Pediatric Nurse Practitioner | — | NULL | — |
| 363LP0200X | Pediatric Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |
| 364S00000X | Clinical Nurse Specialist | — | NULL | — |
| 364S00000X | Clinical Nurse Specialist | — | — | — |

## Other

- **Enumeration date:** 10/31/2006
- **Last updated:** 09/06/2024