Jill A Noack in Grand Rapids - Physician Assistant
Jill A Noack - NPI 1891788261
Jill A Noack is a Physician Assistant in Grand Rapids, Michigan. Jill A Noack practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Jill A Noack is 1891788261. The last update date is 2011-01-12.
Jill A Noack's current location address is 710 Kenmoor Ave Se, Grand Rapids, Michigan. You can contact this provider via phone number 6169549800 and fax number 6169540659. The mailing address for Jill A Noack is 710 Kenmoor Ave Se, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jill A Noack |
|---|---|
| Address | 710 Kenmoor Ave Se, Grand Rapids, Michigan |
| Phone Number | 6169549800 |
| Fax Number | 6169540659 |
| Sole Proprietor | N |
| Credentials | PA C |
NPI Number Detail
| NPI Number | 1891788261 |
|---|---|
| Provider Enumeration Date | 2005-08-31 |
| Last Updated Date | 2011-01-12 |
Provider Mailing Address Detail
| Address | 710 Kenmoor Ave Se |
|---|---|
| City | Grand Rapids |
| State | Michigan (MI) |
| Post Code | 495462379 |
| Phone Number | 6169549800 |
| Fax Number | 6169540659 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 5601001749 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0C91143 | MI | BCBSM | |
| CA3050 | MI | RAILROAD MEDICARE |
Post Comment/ Review Below
What is the Jill A Noack's 1891788261?
The Jill A Noack's NPI (National Provider Identifier) Number is 1891788261. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Where is the Jill A Noack located?
The Jill A Noack is located at 710 Kenmoor Ave Se, Grand Rapids, MI 495462379.
What is Jill A Noack's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Jill A Noack is Physician Assistant, and the taxonomy classification code that categorizes this area of expertise is 363A00000X.
When was the Jill A Noack's 1891788261 issued?
The Jill A Noack's 1891788261 was issued on 2005-08-31.
As of what date were the details related to Jill A Noack most recently updated or revised?
The information pertaining to Jill A Noack, including its address, specialty, and other relevant details, was last updated or revised on 2011-01-12.