1003804881 NPI number — ROSE MARIE FIFE CNM

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003804881 NPI number — ROSE MARIE FIFE CNM

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

FIFE

Provider First Name:

ROSE

Provider Middle Name:

MARIE

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

CNM

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1003804881

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

03/09/2011

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

501 LAPEER

Provider Second Line Business Mailing Address:

HEALTH DELIVERY INC

Provider Business Mailing Address City Name:

SAGINAW

Provider Business Mailing Address State Name:

MI

Provider Business Mailing Address Postal Code:

48607-1208

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

989-759-6464

Provider Business Mailing Address Fax Number:

989-399-8233

Provider First Line Business Practice Location Address:

3175 W PROFESSIONAL DR

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

BAY CITY

Provider Business Practice Location Address State Name:

MI

Provider Business Practice Location Address Postal Code:

48706

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

989-667-3377

Provider Business Practice Location Address Fax Number:

989-667-9991

Provider Enumeration Date:

10/06/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 367A00000X , with the licence number:  4704113509 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 118691 . This is a "GREAT LAKES HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
• Identifier: 9366637 . This is a "CIGNA PHCS" identifier . This identifiers is of the category "OTHER".
• Identifier: 37783 . This is a "HEALTH PLAN OF MICHIGAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
• Identifier: 420G310800 . This is a "BCBS OF MICHIGAN" identifier . This identifiers is of the category "OTHER".
• Identifier: 4529891 . This is a "MOLINA HEALTH CARE OF MI" identifier . This identifiers is of the category "OTHER".
• Identifier: 1009134 . This is a "MCLAREN HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
• Identifier: 210 . This is a "COMMUNITY CHOICE OF MI" identifier . This identifiers is of the category "OTHER".
• Identifier: 420001324 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 1003804881 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
• Identifier: 381908328 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 0995668 . This is a "HEALTHPLUS OF MICHIGAN" identifier . This identifiers is of the category "OTHER".
• Identifier: 1009134 . This is a "HEALTH ADVANTAGE PPO" identifier . This identifiers is of the category "OTHER".
• Identifier: 7330259 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".