| Northern Healthcare Pllc | |
|
2057 S M 66 East Jordan MI 49727-9169 | |
| (231) 649-7109 | |
| Not Available |
| Full Name | Northern Healthcare Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2057 S M 66, East Jordan, Michigan |
| Authorized Official Name and Position | Kimberly Nicholls (OWNER) |
| Authorized Official Contact | 2316497109 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Healthcare Pllc 2057 S M 66 East Jordan MI 49727-9169 Ph: () - | Northern Healthcare Pllc 2057 S M 66 East Jordan MI 49727-9169 Ph: (231) 649-7109 |
| NPI Number | 1932787009 |
|---|---|
| Provider Enumeration Date | 03/31/2021 |
| Last Update Date | 01/20/2022 |
| Medicare PECOS PAC ID | 2163821059 |
|---|---|
| Medicare Enrollment ID | O20210526000695 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932787009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| Provider Name | Rosanne Freeman Paz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205806593 PECOS PAC ID: 6002821097 Enrollment ID: I20060213000337 |
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