| Northridge Family Practice Llc | |
|
3190 Northridge Drive Hale MI 48739-9276 | |
| (989) 728-6000 | |
| (989) 728-6003 |
| Full Name | Northridge Family Practice Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 3190 Northridge Drive, Hale, Michigan |
| Authorized Official Name and Position | Debra Kaye Provoast (MANAGING OFFICER) |
| Authorized Official Contact | 9897286000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northridge Family Practice Llc Po Box 279 Hale MI 48739-0279 Ph: (989) 728-6000 | Northridge Family Practice Llc 3190 Northridge Drive Hale MI 48739-9276 Ph: (989) 728-6000 |
| NPI Number | 1891712493 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 11/02/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891712493 | NPI | - | NPPES |
| 1017859 | Other | MI | MCLAREN |
| 105230710 | Medicaid | MI | |
| BW148660 | Other | MI | BETH WEAVER LICENSE |
| MA061417 | Other | MOHAMED ALI | |
| RAILROAD MEDICARE | Other | MI | P00261196 |
| 4704283185 | Other | MI | LINDSEY LICENSE |
| 104289418 | Medicaid | MI | |
| 105235126 | Medicaid | MI | |
| OC51020 | Other | BLUE CROSS BLUE SHIELD | |
| 1017858 | Other | MI | MCLAREN DEB PROVOAST |
| DP173663 | Other | MI | DEBBIE PROVOAST LICENSE |
| DD9334 | Other | MI | RAILROAD MEDICARE |
Hale Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 436 W Main St, Hale, MI 48739 Phone: 989-728-2800 Fax: 989-654-2348 | |
Mclaren Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 436 W Main St, Hale, MI 48739 Phone: 989-728-6516 Fax: 989-728-6519 | |
Mclaren Bay Region Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 436 W Main St, Hale, MI 48739 Phone: 989-728-6516 Fax: 989-728-6519 | |
Ascension St Joseph Hospital Hale Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3190 Northridge Rd, Hale, MI 48739 Phone: 989-728-6000 Fax: 989-728-6003 | |
Northridge Family Practice Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3190 Northridge Drive, Hale, MI 48739 Phone: 989-728-6000 Fax: 989-728-6003 | |
Thunder Bay Community Health Service, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 311 N Washington St Rm Tb1, Hale, MI 48739 Phone: 989-742-4583 Fax: 989-742-2183 |