Healthcare Provider Details

I. General information

NPI: 1245978436
Provider Name (Legal Business Name): NINA PURTEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2022
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 S 4TH ST STE A
ISHPEMING MI
49849-2168
US

IV. Provider business mailing address

97 S 4TH ST STE C
ISHPEMING MI
49849-2168
US

V. Phone/Fax

Practice location:
  • Phone: 906-485-2347
  • Fax:
Mailing address:
  • Phone: 906-228-9699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: