Healthcare Provider Details

I. General information

NPI: 1104236256
Provider Name (Legal Business Name): CHRISTIANN ROSEMURGY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2014
Last Update Date: 01/01/2025
Certification Date: 01/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MACINNES DR
HOUGHTON MI
49931-1144
US

IV. Provider business mailing address

301 EXPLORER ST
GWINN MI
49841-2813
US

V. Phone/Fax

Practice location:
  • Phone: 906-483-1860
  • Fax: 906-372-3230
Mailing address:
  • Phone: 906-483-1860
  • Fax: 906-372-3230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number4704200956
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number4704200956
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: