1538126222 NPI number — DEBORAH A CARY CNM, CFNP

Table of content: DEBORAH A CARY CNM, CFNP (NPI 1538126222)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538126222 NPI number — DEBORAH A CARY CNM, CFNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARY
Provider First Name:
DEBORAH
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CNM, CFNP
Provider Gender Code:
F

Provider's Other Name Information

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 Information

NPI Number:
1538126222
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/20/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
315 E WARWICK DR
Provider Second Line Business Mailing Address:
SUITE D
Provider Business Mailing Address City Name:
ALMA
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48801-1083
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-466-5486
Provider Business Mailing Address Fax Number:
989-466-2486

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
315 E WARWICK DR
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
ALMA
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48801-1083
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-466-5486
Provider Business Practice Location Address Fax Number:
989-466-5023
Provider Enumeration Date:
04/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  4704102871 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 367A00000X , with the licence number: 4704102871 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4208704690 . This is a "BCBSM" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 500002267 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 104345615 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 103354093 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5008708040 . This is a "BCBSM" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 200000005709 . This is a "PHP COMMERCIAL" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 01006016 . This is a "HEALTHPLUS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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