Roxanne Shudark, is a
Licensed Practical Nurse based in Houghton Lake, Michigan. Roxanne Shudark is licensed to practice in Michigan (license number 4703112155) and her current practice location is
106 Toepher Dr, Houghton Lake, Michigan. She can be reached at her office (for appointments etc.) via phone at
(989) 630-3409.
NPI number for Roxanne Shudark is 1013372515 and her current mailing address is 106 Toepher Dr, Houghton Lake, Michigan. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1013372515.
Provider's Profile
Full Name | Roxanne Shudark |
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Gender | Female |
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Speciality | Licensed Practical Nurse |
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Location | 106 Toepher Dr, Houghton Lake, Michigan |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1013372515
- Provider Enumeration Date: 12/28/2015
- Last Update Date: 12/28/2015
Medical Identifiers
Medical identifiers for Roxanne Shudark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1013372515 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164W00000X | Licensed Practical Nurse | 4703112155 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Roxanne Shudark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Roxanne Shudark, 106 Toepher Dr, Houghton Lake, MI 48629-9278 Ph: (989) 630-3409 | Roxanne Shudark, 106 Toepher Dr, Houghton Lake, MI 48629-9278 Ph: (989) 630-3409 |
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