Healthcare Provider Details

I. General information

NPI: 1992802086
Provider Name (Legal Business Name): CHRISTINE WEBER APRN,BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12851 GRAND RIVER RD
BRIGHTON MI
48116-8506
US

IV. Provider business mailing address

12851 GRAND RIVER RD
BRIGHTON MI
48116-8506
US

V. Phone/Fax

Practice location:
  • Phone: 810-227-1211
  • Fax:
Mailing address:
  • Phone: 810-227-1211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number4770041331460
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: