Organization
MIDWEST MEDFLIGHT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY KETTENSTOCK RN (PROGRAM DIRECTOR)
(734) 712-3104
Entity
Organization
Contact information
Practice address
5305 MCAULEY DR, # 311, YPSILANTI, MI 48197-1051
(734) 712-3104
(816) 431-4973
Mailing address
5305 MCAULEY DR, # 311, YPSILANTI, MI 48197-1051
(734) 712-3104
(816) 431-4973
Taxonomy
Speciality
Code
Description
License number
State
3416A0800X
Air Ambulance
Primary
811007
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59OH10002
BCBSMI
MI
Enumeration date
06/09/2005
Last updated
04/20/2008
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