Mrs Gina R Middlebrook, FNP is a medicare enrolled "Nurse Practitioner" physician in Traverse City, Michigan. Her current practice location is
4075 Copper Ridge Dr, Traverse City, Michigan. You can reach out to her office (for appointments etc.) via phone at
(804) 289-4605.
Mrs Gina R Middlebrook is licensed to practice in Virginia (license number 0024167368) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1699965863.
Physician's Profile
| Full Name | Mrs Gina R Middlebrook |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 4075 Copper Ridge Dr, Traverse City, Michigan |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1699965863
- Provider Enumeration Date: 07/25/2007
- Last Update Date: 01/08/2010
Medicare PECOS Information:
- PECOS PAC ID: 3779677521
- Enrollment ID: I20070924000598
Medical Identifiers
Medical identifiers for Mrs Gina R Middlebrook such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1699965863 | NPI | - | NPPES |
| 1699965863 | Medicaid | VA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207P00000X | Emergency Medicine | 0024167368 (Virginia) | Secondary |
| 363L00000X | Nurse Practitioner | 0024167368 (Virginia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Gina R Middlebrook is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Mrs Gina R Middlebrook, FNP 4075 Copper Ridge Dr, Traverse City, MI 49684-3689 Ph: (804) 289-4605 | Mrs Gina R Middlebrook, FNP 4075 Copper Ridge Dr, Traverse City, MI 49684-7059 Ph: (804) 289-4605 |
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