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General NPI Number Information
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NPI Number | 1831782366
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Entity Type | Individual
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Provider Name | AUSTYN KAY OTTEN NP
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Gender | Female
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Dates
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Enumeration Date | 02/16/2021
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Last Update Date | 03/03/2021
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Provider Practice Location Address
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Address Line | 1509 N MCEWAN ST
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City | CLARE
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State | MI
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Zip | 48617-1113
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Country | US
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Telephone | 989-386-8170
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Fax | 989-386-8175
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Provider Business Mailing Address
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Address Line | 617 NAKOMA DR
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City | MIDLAND
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State | MI
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Zip | 48640-2829
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Country | US
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Telephone | 616-808-6323
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704254199
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License Number State | MI
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