Main Street Family Practice Pc in West Branch - Nurse Practitioner
Main Street Family Practice Pc - NPI 1972706612
Main Street Family Practice Pc is a Nurse Practitioner in West Branch, Michigan. Main Street Family Practice Pc practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for Main Street Family Practice Pc is 1972706612. The last update date is 2009-08-27.
Main Street Family Practice Pc's current location address is 117 S Burgess St, West Branch, Michigan. You can contact this provider via phone number 9893431367 and fax number 9893431427. The mailing address for Main Street Family Practice Pc is 117 S Burgess St, West Branch, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Main Street Family Practice Pc |
|---|---|
| Address | 117 S Burgess St, West Branch, Michigan |
| Phone Number | 9893431367 |
| Fax Number | 9893431427 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | ONWER |
|---|---|
| Authorized Official Name | Louis Elizabeth Marilyn |
| Credentials | CFNP |
| Telephone Number | 9893431367 |
NPI Number Detail
| NPI Number | 1972706612 |
|---|---|
| Provider Enumeration Date | 2007-06-08 |
| Last Updated Date | 2009-08-27 |
Provider Mailing Address Detail
| Address | 117 S Burgess St |
|---|---|
| City | West Branch |
| State | Michigan (MI) |
| Post Code | 486611403 |
| Phone Number | 9893431367 |
| Fax Number | 9893431427 |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Practitioner |
|---|---|
| Taxonomy | 363L00000X |
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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 |
|---|---|---|---|
| 4627355 | MI | -- | |
| 5008703250 | MI | BCBSM |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Main Street Family Practice Pc by the Centers for Medicare & Medicaid Services?
The Main Street Family Practice Pc has been assigned the NPI (National Provider Identifier) 1972706612 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 Main Street Family Practice Pc's physical address?
The Main Street Family Practice Pc is physically located at 117 S Burgess St, in the city of West Branch, MI, with the postal code 486611403.
What is Main Street Family Practice Pc's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Main Street Family Practice Pc's specialized field of practice is Nurse Practitioner, and the corresponding taxonomy code that categorizes this area of specialization is 363L00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1972706612 to Main Street Family Practice Pc?
The Main Street Family Practice Pc received its 1972706612 assignment from the Centers for Medicare & Medicaid Services on 2007-06-08.
As of what date were the details related to Main Street Family Practice Pc most recently updated or revised?
The information pertaining to Main Street Family Practice Pc, including its address, specialty, and other relevant details, was last updated or revised on 2009-08-27.