Healthcare Provider Details

I. General information

NPI: 1770567463
Provider Name (Legal Business Name): CHILD HEALTH PARTNERS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 LAKE LANSING RD C 2
LANSING MI
48912-3753
US

IV. Provider business mailing address

1515 LAKE LANSING RD C 2
LANSING MI
48912-3753
US

V. Phone/Fax

Practice location:
  • Phone: 517-482-9582
  • Fax: 517-482-4304
Mailing address:
  • Phone: 517-482-9582
  • Fax: 517-482-4304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: NANCY ANN SPATES
Title or Position: PRESIDENT CHP
Credential: MD
Phone: 517-482-9582