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Organization

BOTSFORD GENERAL HOSPITAL

Active
Parent organization
BOTSFORD NURSE PRACTITIONER
Organization subpart
Yes

Provider details

NPI number
Legal business name
BOTSFORD NURSE PRACTITIONER
Authorized official
LESLEY WILLBRANDT (DIRECTOR SHARED SERVICES)
(947) 522-1911
Entity
Organization

Contact information

Practice address
28050 GRAND RIVER AVE, FARMINGTON HILLS, MI 48336-5919
(248) 471-8147
Mailing address
26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1060000070
MI

Other

Enumeration date
10/24/2016
Last updated
08/21/2019
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