Individual
MRS. PATI PUTT CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CUNP
Contact information
Practice address
1500 EAST MEDICAL CENTER DRIVE, B1 FLOOR CANCER & GERIATRIC CENTER RECP C, ANN ARBOR, MI 48109-5913
(734) 647-8903
(734) 647-8860
Mailing address
3621 SOUTH STATE STREET, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704211868
MI
Other
Enumeration date
12/28/2006
Last updated
03/26/2013
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