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General NPI Number Information
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NPI Number | 1356596464
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Entity Type | Organization
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Legal Business Name | HEALTHY PATHS
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Dates
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Enumeration Date | 11/18/2008
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Last Update Date | 12/30/2008
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Provider Practice Location Address
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Address Line | 8210 KEWEENAW ST
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City | KALAMAZOO
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State | MI
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Zip | 49009-5957
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Country | US
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Telephone | 269-372-6038
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Fax |
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Provider Business Mailing Address
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Address Line | 8210 KEWEENAW ST
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City | KALAMAZOO
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State | MI
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Zip | 49009-5957
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Country | US
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Telephone | 269-372-6038
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Fax |
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Authorized Official
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Title or Position | NURSE PRACITIONER/OWNER
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Name | DIANA MARIE LOYNES
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Credential | NP
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Telephone | 269-372-6038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 4704142535
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License Number State | MI
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