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Individual

MS. ANNETTE WALBLAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
1500 EAST MEDICAL CENTER DRIVE, LEVEL 3, ANN ARBOR, MI 48109-5856
(888) 287-1082
Mailing address
3621 S STATE STREET, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704155767
MI
363LA2200X
Adult Health Nurse Practitioner
Primary
4704155767
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4762387
MI
01
5008601210
BLUECROSSBLUESHIELD OF MI
MI
Enumeration date
06/25/2006
Last updated
01/02/2009
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