Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 4704247113 | MI |
N | 363LW0102X | Nurse Practitioner - Women's Health | 16471 | TN |
NPI | 1043656564 |
---|---|
Provider Name | Jodi Lynn Spiegelberg |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Brighton, MI 48116-7446 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2013 |
Last Update Date | 11/01/2019 |