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General NPI Number Information
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NPI Number | 1457142069
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Entity Type | Individual
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Provider Name | CARLY JOSEPHINE BAVIER NP
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Gender | Female
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 3512 COOLIDGE RD
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City | EAST LANSING
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State | MI
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Zip | 48823-6376
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Country | US
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Telephone | 877-587-4112
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Fax |
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Provider Business Mailing Address
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Address Line | 106 E MAIN ST
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City | SPRING ARBOR
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State | MI
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Zip | 49283-9701
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2025000785
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704358831
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 83186615
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License Number State | MI
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