Organization
QUINCY INTERMED INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI L JOHNSON (BILLER)
(517) 639-5354
Entity
Organization
Contact information
Practice address
185 E CHICAGO ST, QUINCY, MI 49082-1165
(517) 639-5354
(517) 639-5344
Mailing address
185 E CHICAGO ST, QUINCY, MI 49082-1165
(517) 639-5354
(517) 639-5344
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704213726
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932284973
NPI TYPE 1
MI
05
—
4934955
—
MI
Enumeration date
05/07/2008
Last updated
09/30/2008
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