GRAND TRAVERSE WOMENS CLINIC NPI 1942552559

NPI Information

NPI: 1942552559
Provider Name: GRAND TRAVERSE WOMENS CLINIC
Classification: Nurse Practitioner - 363LX0001X
Entity Type: Organization

Specialization: Obstetrics & Gynecology

Address:
1200 SIXTH ST
STE 400
TRAVERSE CITY, MI
ZIP 49684
Phone: (231) 392-0655
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GRAND TRAVERSE WOMENS CLINIC is an obstetrics and gynecology nurse practitioner in Traverse City, MI. GRAND TRAVERSE WOMENS CLINIC NPI is 1942552559. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1200 SIXTH ST
STE 400
TRAVERSE CITY, MI
ZIP 49684-369
Phone: (231) 392-0655
Fax: (231) 392-0691

The provider's authorized official is Barbara Rogers .
The authorized official title is Credentialing Specialist and has the following contact phone number (231) 392-0655.

The enumeration date for this NPI number is 10/5/2012 and was last updated on 2/24/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LX0001X	Nurse Practitioner	Obstetrics & Gynecology	4704273686	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	4704273686	OTHER	MICHIGAN	LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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