Individual
KRISTIN TEATSORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7226 ALLEN RD, ALLEN PARK, MI 48101-2060
(313) 383-5530
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 876-9490
(313) 876-1305
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704266798
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H28865
BLUE CROSS
MI
01
—
1144634403
GROUP NPI HENRY FORD WYANDOTTE
—
Enumeration date
03/22/2016
Last updated
01/05/2023
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