Healthcare Provider Details

I. General information

NPI: 1972310738
Provider Name (Legal Business Name): THRIVE PRIMARY CARE AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2024
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 E MAUMEE ST STE 1
ADRIAN MI
49221-2735
US

IV. Provider business mailing address

142 E MAUMEE ST STE 1
ADRIAN MI
49221-2735
US

V. Phone/Fax

Practice location:
  • Phone: 517-291-8729
  • Fax: 517-235-5747
Mailing address:
  • Phone: 517-291-8729
  • Fax: 517-235-5747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. RACHEL REDMAN
Title or Position: NURSE PRACTITIONER
Credential: C-NP
Phone: 517-291-8729