Healthcare Provider Details

I. General information

NPI: 1659606242
Provider Name (Legal Business Name): JUDY L CHRISTOFF RN,MSN,OCN,ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2009
Last Update Date: 10/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 WATERTOWER PL STE 500
EAST LANSING MI
48823-6396
US

IV. Provider business mailing address

1550 WATERTOWER PL STE 500
EAST LANSING MI
48823-6396
US

V. Phone/Fax

Practice location:
  • Phone: 517-333-6060
  • Fax: 517-333-6068
Mailing address:
  • Phone: 517-333-6060
  • Fax: 517-333-6068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberL1619587
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: