Debra K Provoast NP

NPI 1033107271 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1033107271
Gender Female
Enumeration Date 10/12/2005
Last Updated 03/24/2014
Entity Type Individual
Active Over 11 years ago
Practice Location
3190 NORTHRIDGE DRIVE
HALE MI, 48739-9276, US
Phone (989) 728-6000
Fax (989) 728-6003
Business Location
PO BOX 279
HALE MI, 48739-0279, US
Phone (989) 728-6000
Fax (989) 728-6003
Toxanomy
Taxonomy Code 363LF0000X
License State Michigan
License Number 4704173663
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According to our database, Debra K Provoast NP NPI is 1033107271, taxonomy code is 363LF0000X and license number is 4704173663, license state is located at Michigan. Debra K Provoast NP physically located at 3190 Northridge Drive, Hale MI, 48739-9276. NPI Number Debra K Provoast NP has the Individual type.

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1033107271 NPI number is provided on an as is basis without warranty of any kind. 1033107271 is maintained by the National Plan & Provider Enumeration System. The contents of Debra K Provoast NP are for informational purposes only.