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General NPI Number Information
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NPI Number | 1811197304
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Entity Type | Individual
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Provider Name | PATTI M PAIGE FNP
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Gender | Female
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 07/23/2007
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Provider Practice Location Address
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Address Line | E23570 CHOATE ROAD
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City | WATERSMEET
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State | MI
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Zip | 49969-0249
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Country | US
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Telephone | 906-358-4588
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Fax | 906-358-4118
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Provider Business Mailing Address
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Address Line | 109 10TH AVE S
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City | HURLEY
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State | WI
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Zip | 54534-1304
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Country | US
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Telephone | 715-561-3197
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Fax | 906-358-4118
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704142121
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License Number State | MI
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