Individual
MS. JUDITH R. GENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NP
Contact information
Practice address
555 TOWNER ST, YPSILANTI, MI 48198-5752
(734) 544-3000
Mailing address
555 TOWNER ST, YPSILANTI, MI 48198-5752
(734) 544-2958
(734) 544-6732
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704167564
MI
363L00000X
Nurse Practitioner
Primary
4704167564
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104996484
—
MI
Enumeration date
01/16/2007
Last updated
03/21/2012
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