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NPI Code Detail

MEDICARE: SUSAN K STRICKFADEN N.P.

MEDICARE: SUSAN K STRICKFADEN N.P.
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 Practitioner4704169028MI

General Provider Information

NPI Number : 1851310361
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN K STRICKFADEN N.P.
Provider Business Mailing Address
First Line : 100 MICHIGAN ST NE # MC845
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49503-2560
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1440 E SHERMAN BLVD STE 300
Second Line :
City : MUSKEGON
State : MI
Zip : 49444-1816
Country : US
Telephone Number : 231-672-2008
Fax Number : 231-672-2009
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 09/25/2020

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