MEDICARE: MR. MICHAEL R. FORBES CFNP

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
1	363LF0000X	Family Nurse Practitioner	61786	OK
2	363LF0000X	Family Nurse Practitioner	74904	KS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110931005	OTHER	KS	PART B MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1881687242	OTHER	KS	BCBS KS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881687242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL R. FORBES CFNP

Provider Business Mailing Address
First Line	:	3011 N MICHIGAN ST
Second Line	:
City	:	PITTSBURG
State	:	KS
Zip	:	66762-2546
Country	:	US
Telephone Number	:	620-231-9873
Fax Number	:	620-231-2808

Provider Business Practice Location Address
First Line	:	120 W PINE ST
Second Line	:
City	:	COLUMBUS
State	:	KS
Zip	:	66725-1705
Country	:	US
Telephone Number	:	620-429-2101
Fax Number	:	620-429-2106

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	11/17/2020

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