Healthcare Provider Details

I. General information

NPI: 1396168514
Provider Name (Legal Business Name): RICHELE KATHERINE MACHT FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SR MARY SARAH MACHT FNP-BC

II. Dates (important events)

Enumeration Date: 01/23/2014
Last Update Date: 09/20/2023
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 W CHEESMAN RD
ALMA MI
48801-9760
US

IV. Provider business mailing address

2025 W CHEESMAN RD
ALMA MI
48801-9760
US

V. Phone/Fax

Practice location:
  • Phone: 989-463-3451
  • Fax: 989-463-1534
Mailing address:
  • Phone: 989-463-3451
  • Fax: 918-488-6098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704298573
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number80430
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: