Healthcare Provider Details

I. General information

NPI: 1407696552
Provider Name (Legal Business Name): VALERIE ELIZABETH WITHROW FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2024
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 NORTH AVE
BATTLE CREEK MI
49017-3396
US

IV. Provider business mailing address

10060 S DR S
BURLINGTON MI
49029-9712
US

V. Phone/Fax

Practice location:
  • Phone: 269-245-8000
  • Fax:
Mailing address:
  • Phone: 517-781-0467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704354044
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: