| Beth Sipple Janick Llc | |
|
4572 S Hagadorn Rd Suite 3b East Lansing MI 48823-5385 | |
| (517) 410-0729 | |
| (517) 999-3675 |
| Full Name | Beth Sipple Janick Llc |
|---|---|
| Speciality | Counselor |
| Location | 4572 S Hagadorn Rd, East Lansing, Michigan |
| Authorized Official Name and Position | Beth Sipple Janick (NURSE PRACTITIONER) |
| Authorized Official Contact | 5174100729 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beth Sipple Janick Llc 4572 S Hagadorn Rd Suite 3b East Lansing MI 48823-5385 Ph: (517) 410-0729 | Beth Sipple Janick Llc 4572 S Hagadorn Rd Suite 3b East Lansing MI 48823-5385 Ph: (517) 410-0729 |
| NPI Number | 1104209493 |
|---|---|
| Provider Enumeration Date | 07/03/2015 |
| Last Update Date | 07/30/2015 |
| Medicare PECOS PAC ID | 1355656042 |
|---|---|
| Medicare Enrollment ID | O20150810001399 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104209493 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 4704194601 (Michigan) | Primary |
| Provider Name | Beth S Janick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073626057 PECOS PAC ID: 1254308075 Enrollment ID: I20040913000284 |
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