Advanced Practice Primary Care Staff Associates | |
27160 Deerfield Ln Edwardsburg MI 49112-9663 | |
(574) 485-9541 | |
Not Available |
Full Name | Advanced Practice Primary Care Staff Associates |
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Speciality | Clinic/Center |
Location | 27160 Deerfield Ln, Edwardsburg, Michigan |
Authorized Official Name and Position | Elizabeth A Van Overberghe (FAMILY NURSE PRACTITIONER) |
Authorized Official Contact | 5744859541 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Advanced Practice Primary Care Staff Associates 27160 Deerfield Ln Edwardsburg MI 49112-9663 Ph: (574) 485-9541 | Advanced Practice Primary Care Staff Associates 27160 Deerfield Ln Edwardsburg MI 49112-9663 Ph: (574) 485-9541 |
NPI Number | 1558029983 |
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Provider Enumeration Date | 12/02/2021 |
Last Update Date | 02/18/2022 |
Medicare PECOS PAC ID | 5092108290 |
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Medicare Enrollment ID | O20220211000449 |
Identifier | Type | State | Issuer |
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1558029983 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Elizabeth Van Overberghe |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558954495 PECOS PAC ID: 1254733967 Enrollment ID: I20220211000552 |
Beacon Medical Group Edwardsburg Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 27082 W Main Street, Edwardsburg, MI 49112 Phone: 269-663-8288 Fax: 269-663-2426 | |
Healthy Cocoon Practice Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 27082 W. Main Street, Edwardsburg, MI 49112 Phone: 269-246-1375 Fax: 269-246-1376 |