Traci J Van Gorden is a Family in Sturgis, Michigan. Traci J Van Gorden practices all healthcare services and medical treatments related to Family. The NPI Number for Traci J Van Gorden is 1679513451. The last update date is 2020-11-05.
Traci J Van Gorden's current location address is 104 S Lakeview Ave, Sturgis, Michigan. You can contact this provider via phone number 2693198850. The mailing address for Traci J Van Gorden is 104 S Lakeview Ave, Sturgis, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Traci J Van Gorden |
|---|---|
| Address | 104 S Lakeview Ave, Sturgis, Michigan |
| Phone Number | 2693198850 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | CFNP |
NPI Number Detail
| NPI Number | 1679513451 |
|---|---|
| Provider Enumeration Date | 2006-06-08 |
| Last Updated Date | 2020-11-05 |
Provider Mailing Address Detail
| Address | 104 S Lakeview Ave |
|---|---|
| City | Sturgis |
| State | Michigan (MI) |
| Post Code | 490911947 |
| Phone Number | 2693198850 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | 4704252117 |
|
Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4888010 | MI | -- | |
| 4887990 | MI | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Traci J Van Gorden?
The Traci J Van Gorden has been issued the NPI (National Provider Identifier) 1679513451 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete street address where Traci J Van Gorden is physically located?
The Traci J Van Gorden is physically situated at the following address: 104 S Lakeview Ave, Sturgis, MI, 490911947.
What is Traci J Van Gorden's area of expertise and its corresponding taxonomy classification?
The Traci J Van Gorden's field of specialization is Family, and it falls under the taxonomy code 363Lf0000X, which categorizes healthcare providers based on their areas of practice.
When did Traci J Van Gorden receive its 1679513451 assignment?
The Traci J Van Gorden was assigned its 1679513451 on 2006-06-08, which is the date when this unique identifier was issued to the organization.
As of what date were the Traci J Van Gorden's details last updated?
The information pertaining to the Traci J Van Gorden, including its address, specialty, and other details, was most recently updated on 2020-11-05.