Healthcare Provider Details

I. General information

NPI: 1952003352
Provider Name (Legal Business Name): CONNECTED HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4277 OKEMOS RD STE 100
OKEMOS MI
48864-3282
US

IV. Provider business mailing address

4277 OKEMOS RD STE 100
OKEMOS MI
48864-3282
US

V. Phone/Fax

Practice location:
  • Phone: 517-816-8723
  • Fax: 517-247-3558
Mailing address:
  • Phone: 517-816-8723
  • Fax: 517-247-3558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER T HOFFMAN
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 269-870-5969