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NPI Code Detail

MEDICARE: TAMARA POBOCIK PMHNP-BC

MEDICARE: TAMARA POBOCIK PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner4704177017MI

General Provider Information

NPI Number : 1740816289
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMARA POBOCIK PMHNP-BC
Provider Business Mailing Address
First Line : 10801 S SAGINAW ST STE D
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-8126
Country : US
Telephone Number : 810-771-4074
Fax Number : 810-662-0672
Provider Business Practice Location Address
First Line : 10801 S SAGINAW ST STE D
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-8126
Country : US
Telephone Number : 810-771-4074
Fax Number : 810-662-0672
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2020
Last Update Date : 04/23/2026

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