Individual
MS. SALLY JANE BERNBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN-BC
Contact information
Practice address
1500 EAST MEDICAL CENTER DR, B1 FLOOR UNIVERSITY HOSPITAL RECP C, ANN ARBOR, MI 48109-0030
(734) 936-4566
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704084113
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4737910
—
MI
Enumeration date
10/31/2006
Last updated
10/18/2007
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