Individual
JENNIFER BURGTORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25000 HALL RD STE 1, WOODHAVEN, MI 48183-5112
(734) 676-3373
Mailing address
25000 HALL RD, STE 1, WOODHAVEN, MI 48183-5112
(734) 676-3373
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
4704286508
MI
363LG0600X
Gerontology Nurse Practitioner
4704286508
MI
363LP2300X
Primary Care Nurse Practitioner
Primary
4704286508
MI
Other
Enumeration date
08/16/2015
Last updated
10/09/2024
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