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General NPI Number Information
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NPI Number | 1407949191
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Entity Type | Organization
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Legal Business Name | MUNSON HEALTHCARE MANISTEE HOSPITAL
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 1465 E PARKDALE AVE
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City | MANISTEE
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State | MI
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Zip | 49660-9785
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Country | US
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Telephone | 231-398-1000
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Fax | 231-398-0364
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Provider Business Mailing Address
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Address Line | 1465 E PARKDALE AVE
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City | MANISTEE
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State | MI
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Zip | 49660-9785
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Country | US
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Telephone | 231-398-1000
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Fax | 231-398-0364
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Authorized Official
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Title or Position | PRESIDENT/CEO SOUTH REGION
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Name | KIRSTEN BETHANY KORTH-WHITE
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Credential |
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Telephone | 989-348-0720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number |
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 510020
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License Number State | MI
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