Eva Dafoe

Individual provider Active NPI Licensed Practical Nurse · Pinconning, MI

NPI 1093499485 · NPPES record last updated Jun 14, 2023

Key facts

NPI
1093499485
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
4703099331 (MI)
Practice address
127 S Water St
Pinconning, MI 48650-9704
Phone
(989) 324-9427
NPI assigned
Jun 14, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4703099331MIMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703099331 MI Yes

Addresses

Primary practice location

127 S Water St
Pinconning, MI 48650-9704

Mailing address

127 S Water St
Pinconning, MI 48650-9704
Phone (989) 324-9427

Other providers in Pinconning, MI

All providers in Pinconning, MI · Licensed Practical Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.