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General NPI Number Information
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NPI Number | 1699681312
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Entity Type | Individual
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Provider Name | MALLORY DEGEN RN
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Gender | Female
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Dates
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Enumeration Date | 08/21/2026
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Last Update Date | 08/21/2026
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Provider Practice Location Address
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Address Line | 1500 W CHISHOLM ST
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City | ALPENA
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State | MI
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Zip | 49707
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Country | US
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Telephone | 989-356-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 7691 NICHOLSON HILL RD
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City | HUBBARD LAKE
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State | MI
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Zip | 49747-9511
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704420465
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License Number State | MI
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