| Advanced Practice Primary Care Staff Associates | |
| 
					27160 Deerfield Ln Edwardsburg MI 49112-9663  | |
| (574) 485-9541 | |
| Not Available | 
| Full Name | Advanced Practice Primary Care Staff Associates | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 27160 Deerfield Ln, Edwardsburg, Michigan | 
| Authorized Official Name and Position | Elizabeth A Van Overberghe (FAMILY NURSE PRACTITIONER) | 
| Authorized Official Contact | 5744859541 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Advanced Practice Primary Care Staff Associates 27160 Deerfield Ln Edwardsburg MI 49112-9663 Ph: (574) 485-9541  | Advanced Practice Primary Care Staff Associates 27160 Deerfield Ln Edwardsburg MI 49112-9663 Ph: (574) 485-9541  | 
| NPI Number | 1558029983 | 
|---|---|
| Provider Enumeration Date | 12/02/2021 | 
| Last Update Date | 02/18/2022 | 
| Medicare PECOS PAC ID | 5092108290 | 
|---|---|
| Medicare Enrollment ID | O20220211000449 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1558029983 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary | 
| Provider Name | Elizabeth Van Overberghe | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1558954495 PECOS PAC ID: 1254733967 Enrollment ID: I20220211000552  | 
Beacon Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 27082 W Main Street, Edwardsburg, MI 49112 Phone: 269-663-8288 Fax: 269-663-2426  | |
Healthy Cocoon Practice Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 27082 W. Main Street, Edwardsburg, MI 49112 Phone: 269-246-1375 Fax: 269-246-1376  |