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NPI Code Detail

MEDICARE: ANN MARIE ROEHRS FNP

MEDICARE: ANN MARIE ROEHRS FNP
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
1363LF0000XFamily Nurse Practitioner4704191364MI

General Provider Information

NPI Number : 1407169832
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANN MARIE ROEHRS FNP
Provider Business Mailing Address
First Line : 9249 W LAKE CITY RD
Second Line : MIDMICHIGAN HEALTH SERVICES
City : HOUGHTON LAKE
State : MI
Zip : 48629-9602
Country : US
Telephone Number : 989-422-5122
Fax Number : 989-422-4378
Provider Business Practice Location Address
First Line : 439 S ROSS ST
Second Line : MIDMICHIGAN MEDICAL OFFICES-BEAVERTON
City : BEAVERTON
State : MI
Zip : 48612-9101
Country : US
Telephone Number : 989-246-3500
Fax Number : 989-246-3519
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2010
Last Update Date : 10/26/2012

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