# SPECTRUM HEALTH HOSPITAL-CNP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SPECTRUM HEALTH HOSPITAL
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1841430600
- **Legal business name:** SPECTRUM HEALTH HOSPITAL
- **Authorized official:** BRIAN DESSOY (SENIOR DIRECTOR BSC)
- **Authorized official phone:** (616) 643-9145

## Contact information

- **Practice address:** 100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
- **Practice address phone:** (616) 391-1774
- **Mailing address:** 100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560

## Taxonomy

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

## Other

- **Enumeration date:** 03/05/2009
- **Last updated:** 03/06/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0D11130 | BCBS GROUP PIN 0D11130 | MI |