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Organization
INNOVATIVE HEALTH AT HOME
Active
Organization
INNOVATIVE HEALTH AT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY JOAN VAZQUEZ (MEDICAL SERVICES ADMINISTRATOR)
(231) 733-3525
Entity
Organization
Contact information
Practice address
560 SEMINOLE RD, NORTON SHORES, MI 49444-3720
(231) 733-3525
Mailing address
560 SEMINOLE RD, NORTON SHORES, MI 49444-3720
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
—
NULL
363LG0600X
Gerontology Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/16/2020
Last updated
11/13/2024
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