Healthcare Provider Details

I. General information

NPI: 1447866330
Provider Name (Legal Business Name): JENNIFER ARMSTRONG NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER BOOP NP-C

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14700 LAKE SHORE DR
CHARLEVOIX MI
49720-1931
US

IV. Provider business mailing address

1105 SIXTH ST
TRAVERSE CITY MI
49684-2345
US

V. Phone/Fax

Practice location:
  • Phone: 231-547-4024
  • Fax:
Mailing address:
  • Phone: 231-935-5000
  • Fax: 989-358-3780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704293980
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: