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General NPI Number Information
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NPI Number | 1588155444
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Entity Type | Individual
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Provider Name | TIMOTHY BAGGETT NP-C
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Gender | Male
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Dates
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Enumeration Date | 05/25/2018
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Last Update Date | 05/25/2018
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Provider Practice Location Address
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Address Line | 7700 E MICHIGAN AVE
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City | SALINE
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State | MI
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Zip | 48176-1721
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Country | US
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Telephone | 734-429-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 140 MULBERRY ST
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City | WYANDOTTE
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State | MI
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Zip | 48192-4628
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Country | US
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Telephone | 734-752-0101
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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 | 363LX0106X
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Taxonomy Name | Occupational Health Nurse Practitioner
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License Number | 4704286675
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License Number State | MI
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