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General NPI Number Information
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NPI Number | 1811689144
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Entity Type | Individual
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Provider Name | DOUGLAS JOHAN ABRAHAM APRN, FNP-C, ENP-C,
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Gender | Male
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 03/22/2025
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Provider Practice Location Address
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Address Line | 2 MICHIGAN AVE W STE 201
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City | BATTLE CREEK
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State | MI
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Zip | 49017-3621
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Country | US
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Telephone | 269-282-9022
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Fax | 844-332-3887
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Provider Business Mailing Address
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Address Line | PO BOX 670
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City | BATTLE CREEK
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State | MI
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Zip | 49016-0670
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Country | US
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Telephone | 269-282-9022
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Fax | 844-332-3887
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704341949
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | E3282482
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 52167
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License Number State | WY
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Taxonomy #4
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Taxonomy Code | 163WF0300X
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Taxonomy Name | Flight Registered Nurse
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License Number | 90980
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License Number State | HI
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 52167
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License Number State | WY
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Taxonomy #6
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Taxonomy Code | 363LC0200X
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Taxonomy Name | Critical Care Medicine Nurse Practitioner
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License Number | 52167
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License Number State | WY
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