OTSEGO FAMILY MEDICAL PRACTICE PLLC NPI 1801920533

NPI Information

NPI: 1801920533
Provider Name: OTSEGO FAMILY MEDICAL PRACTICE, PLLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
34471 NORTH DR
GOBLES, MI
ZIP 49055
Phone: (269) 628-2789
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OTSEGO FAMILY MEDICAL PRACTICE, PLLC is a family nurse practitioner in Gobles, MI. OTSEGO FAMILY MEDICAL PRACTICE, PLLC NPI is 1801920533. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

34471 NORTH DR
GOBLES, MI
ZIP 49055-670
Phone: (269) 628-2789

The provider's authorized official is Fred D Boothby .
The authorized official title is Owner and has the following contact phone number (269) 628-4997.

The enumeration date for this NPI number is 3/15/2007 and was last updated on 8/22/2020.

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	363LF0000X	Nurse Practitioner	Family	4704142595	MICHIGAN	Yes

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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