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NPI Code Detail

MEDICARE: MARLYCE R KLOPPING-DAVIS CNM

MEDICARE:   MARLYCE R KLOPPING-DAVIS  CNM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice Midwife4704216085MI

General Provider Information

NPI Number : 1033399589
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLYCE R KLOPPING-DAVIS CNM
Provider Business Mailing Address
First Line : 2758 RIDGEWOOD TRL
Second Line :
City : BERRIEN SPRINGS
State : MI
Zip : 49103-9785
Country : US
Telephone Number : 269-471-7025
Fax Number :
Provider Business Practice Location Address
First Line : 2758 RIDGEWOOD TRL
Second Line :
City : BERRIEN SPRINGS
State : MI
Zip : 49103-9785
Country : US
Telephone Number : 269-471-7025
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2007
Last Update Date : 11/13/2007

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Directions to “ MARLYCE R KLOPPING-DAVIS CNM” Practice Location

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