Pine Rest Christian Mental Health Services in Grand Rapids - Nurse Practitioner
Pine Rest Christian Mental Health Services - NPI 1679777049
Pine Rest Christian Mental Health Services is a Nurse Practitioner in Grand Rapids, Michigan. Pine Rest Christian Mental Health Services practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for Pine Rest Christian Mental Health Services is 1679777049. The last update date is 2020-11-04.
Pine Rest Christian Mental Health Services's current location address is 300 68th St Se, Grand Rapids, Michigan. You can contact this provider via phone number 6164555000. The mailing address for Pine Rest Christian Mental Health Services is 300 68th St Se, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Pine Rest Christian Mental Health Services |
|---|---|
| Address | 300 68th St Se, Grand Rapids, Michigan |
| Phone Number | 6164555000 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MANAGED CA |
|---|---|
| Authorized Official Name | Fennema Diane |
| Telephone Number | 6162816372 |
NPI Number Detail
| NPI Number | 1679777049 |
|---|---|
| Provider Enumeration Date | 2007-06-12 |
| Last Updated Date | 2020-11-04 |
Provider Mailing Address Detail
| Address | 300 68th St Se |
|---|---|
| City | Grand Rapids |
| State | Michigan (MI) |
| Post Code | 495486927 |
| Phone Number | 6164555000 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Practitioner |
|---|---|
| Taxonomy | 363L00000X |
|
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 |
|---|---|---|---|
| 750920290 | MI | BCBS DETOX |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Pine Rest Christian Mental Health Services by the Centers for Medicare & Medicaid Services?
The Pine Rest Christian Mental Health Services has been assigned the NPI (National Provider Identifier) 1679777049 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Can you provide the Pine Rest Christian Mental Health Services's physical address?
The Pine Rest Christian Mental Health Services is physically located at 300 68Th St Se, in the city of Grand Rapids, MI, with the postal code 495486927.
What is Pine Rest Christian Mental Health Services'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 Pine Rest Christian Mental Health Services is Nurse Practitioner, and the taxonomy classification code that categorizes this area of expertise is 363L00000X.
When was the Pine Rest Christian Mental Health Services's 1679777049 issued?
The Pine Rest Christian Mental Health Services's 1679777049 was issued on 2007-06-12.
As of what date were the details pertaining to Pine Rest Christian Mental Health Services last refreshed?
The information related to the Pine Rest Christian Mental Health Services, including its address, specialty, and other relevant details, was last updated on 2020-11-04.
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