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NPI Code Detail

MEDICARE: KIMMEL MARIE GRIWATSCH RN

MEDICARE:   KIMMEL MARIE GRIWATSCH  RN
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
1363LA2200XAdult Health Nurse Practitioner4704266517MI

General Provider Information

NPI Number : 1457220766
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMMEL MARIE GRIWATSCH RN
Provider Business Mailing Address
First Line : 737 N EAST AVE
Second Line :
City : JACKSON
State : MI
Zip : 49202-3422
Country : US
Telephone Number : 517-425-9147
Fax Number : 517-689-5938
Provider Business Practice Location Address
First Line : 605 W CHICAGO RD
Second Line :
City : COLDWATER
State : MI
Zip : 49036-8400
Country : US
Telephone Number : 517-425-9147
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2025
Last Update Date : 04/21/2026

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Directions to “ KIMMEL MARIE GRIWATSCH RN” Practice Location

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