Healthcare Provider Details

I. General information

NPI: 1275849390
Provider Name (Legal Business Name): JEANNETTE ABNEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2010
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 ALPINE AVE NW 577
COMSTOCK PARK MI
49321-8033
US

IV. Provider business mailing address

304 S MAPLE ST SE D
CALEDONIA MI
49316-8947
US

V. Phone/Fax

Practice location:
  • Phone: 313-720-6791
  • Fax:
Mailing address:
  • Phone: 616-536-2277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code282NW0100X
TaxonomyWomen's Hospital
License Number
License Number State

VIII. Authorized Official

Name: JEANNETTE ABNEY
Title or Position: PRESIDENT/CEO
Credential:
Phone: 616-536-2277