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General NPI Number Information
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NPI Number | 1952282139
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Entity Type | Individual
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Provider Name | JERICHO KEEPER KOCOT FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 09/11/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 501 LAPEER AVE
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City | SAGINAW
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State | MI
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Zip | 48607-1203
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Country | US
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Telephone | 989-753-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 2578 E PINCONNING RD
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City | PINCONNING
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State | MI
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Zip | 48650-9339
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Country | US
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Telephone | 989-233-9262
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2025244994
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License Number State | MI
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