MEDICARE: HENRY FORD HEALTH GENESYS HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist		MI

General Provider Information

NPI Number	:	1558517367
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HENRY FORD HEALTH GENESYS HOSPITAL

Provider Business Mailing Address
First Line	:	1 GENESYS PKWY
Second Line	:	DEPARTMENT OF ANESTHESIA
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-8065
Country	:	US
Telephone Number	:	810-606-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 GENESYS PKWY
Second Line	:	DEPARTMENT OF ANESTHESIA
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-8065
Country	:	US
Telephone Number	:	810-606-5000
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KIMBERLY CEBALT
Credential	:
Telephone Number	:	313-874-6764

Provider Enumeration Date	:	08/12/2008
Last Update Date	:	01/19/2026

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