Organization · Type 2 NPI

W.a. Foote Memorial Hospital, Inc

Nurse Practitioner · Jackson, MI

NPI number 1629000708 Active

Practice location

205 N East Ave
Jackson, MI 49201-1753

Call (517) 788-4800 Map

Mailing address

PO Box 670884
Detroit, MI 48267-2728

Specialties and licenses

Taxonomy	Code	License
Nurse Practitioner Primary	363L00000X	None listed

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

620 other providers at this address

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NPI record

NPI: 1629000708
Entity type: Organization (Type 2)
Issued: Jul 7, 2006
Last updated: Oct 9, 2026
Status: Active
Subpart: Yes of Wa Foote Memorial Hospital, Inc

Other names

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Henry Ford Allegiance Health · doing business as
Henry Ford Jackson Health · doing business as

Authorized official

Kimberly Cebalt
Director
(313) 874-6764

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1629000708

W.a. Foote Memorial Hospital, Inc's National Provider Identifier is 1629000708, issued on Jul 7, 2006. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Jackson, MI. The record was last updated on Oct 9, 2026.