Active NPI
Kathleen Ann Nutt
- Behavior Technician
- Prudenville, MI
National Provider Identifier
1124528096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1070 W Houghton Lake Dr
Prudenville, MI 48651-9673 - Phone
- (989) 422-0279
- NPI assigned
- Feb 17, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1070 W Houghton Lake Dr
Prudenville, MI 48651-9673
Mailing address
206 Maple St
Houghton Lake, MI 48629-9764
Phone (810) 407-0440
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518825600000",
"number": "1124528096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 MAPLE ST",
"city": "HOUGHTON LAKE",
"state": "MI",
"postal_code": "486299764",
"telephone_number": "810-407-0440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1070 W HOUGHTON LAKE DR",
"city": "PRUDENVILLE",
"state": "MI",
"postal_code": "486519673",
"telephone_number": "989-422-0279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUTT",
"first_name": "KATHLEEN",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-17",
"last_updated": "2018-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prudenville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.