Facts
- Status
- A
- Credential
- DNP, FNP-BC
- Type
- Individual
- Enumeration date
- 2018-08-22
- Last updated
- 2018-08-22
Specialties
Licenses
- License MI
- 4704210330
Location
- Practice location
- 2648 STATE HIGHWAY M35
- City
- BARK RIVER MI
- Postal code
- 498079727
- Phone
- 906-399-9605
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.