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NPI Code Detail

MEDICARE: MRS. AMY DIANA BABCOCK NP

MEDICARE: MRS. AMY DIANA BABCOCK NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner4704244645MI

General Provider Information

NPI Number : 1447796263
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMY DIANA BABCOCK NP
Provider Business Mailing Address
First Line : 14231 BEADLE LAKE RD
Second Line :
City : BATTLE CREEK
State : MI
Zip : 49014-8213
Country : US
Telephone Number : 269-362-0441
Fax Number :
Provider Business Practice Location Address
First Line : 14231 BEADLE LAKE RD
Second Line :
City : BATTLE CREEK
State : MI
Zip : 49014-8213
Country : US
Telephone Number : 269-362-0441
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2017
Last Update Date : 01/18/2017

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