Individual
JEMILA ALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3950 SPARKS DR SE, GRAND RAPIDS, MI 49546-6159
(616) 726-1318
Mailing address
3475 BELLE CHASE WAY, LANSING, MI 48911-4252
(517) 882-3732
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
470474701
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704274701
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D12824
BCBS
MI
Enumeration date
09/09/2021
Last updated
09/09/2024
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