| Nurse Practitioner Services Of Michiana | |
|
2901 E Bristol St Ste B Elkhart IN 46514-4385 | |
| (574) 622-1522 | |
| (833) 310-2090 |
| Full Name | Nurse Practitioner Services Of Michiana |
|---|---|
| Speciality | Clinic/Center |
| Location | 2901 E Bristol St Ste B, Elkhart, Indiana |
| Authorized Official Name and Position | Kertes Stephanie (OWNER) |
| Authorized Official Contact | 5742743925 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nurse Practitioner Services Of Michiana 2901 E Bristol St Ste B Elkhart IN 46514-4385 Ph: (574) 622-1522 | Nurse Practitioner Services Of Michiana 2901 E Bristol St Ste B Elkhart IN 46514-4385 Ph: (574) 622-1522 |
| NPI Number | 1225605207 |
|---|---|
| Provider Enumeration Date | 06/08/2021 |
| Last Update Date | 11/01/2022 |
| Medicare PECOS PAC ID | 4183024821 |
|---|---|
| Medicare Enrollment ID | O20210616003131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225605207 | NPI | - | NPPES |
| 201317770 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Stephanie Kay Kertes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326414160 PECOS PAC ID: 7911215363 Enrollment ID: I20151005000415 |
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