| NPI | 1598391336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY ELLER Credentialing COO Rindator 231-672-2120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2023-10-05 |