Organization
W.A. FOOTE MEMORIAL HOSPITAL, INC
Active
Parent organization
ALLEGIANCE HEALTH SERVICES
Other names
Henry Ford Allegiance Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALLEGIANCE HEALTH SERVICES
Authorized official
MARK SMITH (SVP, CMO, CEO)
(517) 205-6407
Entity
Organization
Contact information
Practice address
205 N. EAST AVE, JACKSON, MI 49201
(517) 205-7843
Mailing address
PO BOX 67000, DEPARTMENT 272801, DETROIT, MI 48267-2728
(517) 205-7843
(517) 841-7419
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1060000044
MI
363LA2100X
Acute Care Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629000708
—
MI
Enumeration date
01/13/2017
Last updated
07/29/2024
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