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General NPI Number Information
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NPI Number | 1073038758
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Entity Type | Organization
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Legal Business Name | BLUE HILLS MEDICAL PLLC
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Dates
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Enumeration Date | 08/03/2017
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 12068 36TH ST SE
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City | LOWELL
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State | MI
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Zip | 49331-9509
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Country | US
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Telephone | 928-800-1228
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Fax | 928-268-1068
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Provider Business Mailing Address
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Address Line | 12068 36TH ST SE
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City | LOWELL
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State | MI
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Zip | 49331-9509
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Country | US
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Telephone | 928-800-1228
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Fax | 928-268-0143
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Authorized Official
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Title or Position | CEO
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Name | HOLLY ENGELMAN
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Credential | NP
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Telephone | 928-800-1228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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