Healthcare Provider Details

I. General information

NPI: 1568084440
Provider Name (Legal Business Name): ANNETTE MARIE PRINGLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2020
Last Update Date: 05/13/2020
Certification Date: 05/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19251 DOYLE RD
GREGORY MI
48137-9405
US

IV. Provider business mailing address

19275 DOYLE RD
GREGORY MI
48137-9405
US

V. Phone/Fax

Practice location:
  • Phone: 734-498-2277
  • Fax: 734-498-2601
Mailing address:
  • Phone: 734-498-2601
  • Fax: 734-498-2601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: