MEDICARE: MS. NANETTE MARIE HARING N.P.

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
1	363LF0000X	Family Nurse Practitioner	4704154258	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	500C912770	OTHER	MI	BCBSM

General Provider Information

NPI Number	:	1063416972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NANETTE MARIE HARING N.P.

Provider Business Mailing Address
First Line	:	222 N KALAMAZOO MALL
Second Line	:	SUITE 100
City	:	KALAMAZOO
State	:	MI
Zip	:	49007-3881
Country	:	US
Telephone Number	:	269-345-0273
Fax Number	:	269-345-8522

Provider Business Practice Location Address
First Line	:	222 N KALAMAZOO MALL
Second Line	:	SUITE 100
City	:	KALAMAZOO
State	:	MI
Zip	:	49007-3881
Country	:	US
Telephone Number	:	269-345-0273
Fax Number	:	269-345-8522

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	11/27/2023

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