Healthcare Provider Details

I. General information

NPI: 1972626778
Provider Name (Legal Business Name): WENDY L. VALHOFF CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 W GRAND BLVD HENRY FORD HOSPITAL
DETROIT MI
48202-2608
US

IV. Provider business mailing address

28466 ELDORADO PL
LATHRUP VILLAGE MI
48076-2621
US

V. Phone/Fax

Practice location:
  • Phone: 313-790-0685
  • Fax:
Mailing address:
  • Phone: 248-557-7544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number4704172096
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: