Fred Boothby is a Nurse Practitioner in Allegan, Michigan. Fred Boothby practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for Fred Boothby is 1962483271. The last update date is 2008-01-18.
Fred Boothby's current location address is 3285 122nd Ave, Allegan, Michigan. You can contact this provider via phone number 2696736617 and fax number 2696732738. The mailing address for Fred Boothby is 3285 122nd Ave, Allegan, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Fred Boothby |
|---|---|
| Address | 3285 122nd Ave, Allegan, Michigan |
| Phone Number | 2696736617 |
| Fax Number | 2696732738 |
| Sole Proprietor | N |
| Credentials | CNP |
NPI Number Detail
| NPI Number | 1962483271 |
|---|---|
| Provider Enumeration Date | 2005-11-14 |
| Last Updated Date | 2008-01-18 |
Provider Mailing Address Detail
| Address | 3285 122nd Ave |
|---|---|
| City | Allegan |
| State | Michigan (MI) |
| Post Code | 490109511 |
| Phone Number | 2696736617 |
| Fax Number | 2696732738 |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Practitioner |
|---|---|
| Taxonomy | 363L00000X |
| Licence No | 4704142595 |
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Definition: (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 certifi |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4699274 | MI | -- | |
| 5008704740 | MI | BCBS |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Fred Boothby by the Centers for Medicare & Medicaid Services?
The Fred Boothby has been assigned the NPI (National Provider Identifier) 1962483271 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you kindly provide the complete physical address where Fred Boothby's facilities are geographically located?
The facilities of Fred Boothby are physically situated at the following location: 3285 122Nd Ave, Allegan, MI, 490109511.
What is Fred Boothby's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Fred Boothby's specialized field of practice is Nurse Practitioner, and the corresponding taxonomy code that categorizes this area of specialization is 363L00000X.
When did Fred Boothby receive its 1962483271 assignment?
The Fred Boothby was assigned its 1962483271 on 2005-11-14, which is the date when this unique identifier was issued to the organization.
When was the information regarding Fred Boothby, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Fred Boothby, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2008-01-18.
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