Healthcare Provider Details

I. General information

NPI: 1043295967
Provider Name (Legal Business Name): CHRISTINE ANN NEFCY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1023 BUSINESS PARK DR
TRAVERSE CITY MI
49686-8372
US

IV. Provider business mailing address

2100 RAYBROOK ST SE STE 100B
GRAND RAPIDS MI
49546-5782
US

V. Phone/Fax

Practice location:
  • Phone: 616-320-0069
  • Fax: 616-320-0097
Mailing address:
  • Phone: 616-320-0096
  • Fax: 616-320-0097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number70443801205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301089636
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: