Northridge Family Practice LLC
Northridge Family Practice LLC is an Internal Medicine Physician in Hale, Michigan. Licensed in Michigan. Registered with an NPI since 2006.
- Licensed in
- MI
- In the registry since
- 2006
- Specialties on file
- 5
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
3190 Northridge DrHale, MI 48739-9276
Phone: (989) 728-6000
Fax: (989) 728-6003
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Nurse Practitioner (primary) | Taxonomy 363L00000X · Licence 4704173663 (MI) |
|---|---|
| Internal Medicine Physician | Taxonomy 207R00000X · Licence 4301061417 (MI) |
| Nurse Practitioner | Taxonomy 363L00000X · Licence 4704148660 (MI) |
| Family Nurse Practitioner | Taxonomy 363LF0000X · Licence 4704245250 (MI) |
| Family Nurse Practitioner | Taxonomy 363LF0000X · Licence 4704283185 (MI) |
Record details
| NPI number | 1891712493 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Debra Provoast — Managing Officer · (989) 728-6000 |
| NPI enumerated | July 17, 2006 |
| Last updated in NPPES | November 2, 2015 |
| Mailing address | Po Box 279, Hale, MI 48739-0279 |
Other providers in Hale
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Northridge Family Practice LLC
3190 Northridge Dr, Hale, MI 48739-9276 · (989) 728-6000