Organization
ST. JOHN HOSPITAL AND MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIM LEE MCCULLEN CNNP (NEONATAL NURSE PRACTITIONER)
(313) 343-3497
Entity
Organization
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-3497
(313) 417-2967
Mailing address
21183 KENMORE AVE, HARPER WOODS, MI 48225-1705
(313) 886-4257
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
Primary
4704207081
MI
Other
Enumeration date
01/11/2007
Last updated
02/24/2009
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