Roxanne Marie Bliss, AT, ATC
Individual provider Active NPI Athletic Trainer · Kent City, MI
NPI 1144788415 · NPPES record last updated Mar 6, 2019
Key facts
- NPI
- 1144788415
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 2601002050 (MI)
- Practice address
- 15553 Barber Creek Ave
Kent City, MI 49330-9075 - Phone
- (616) 329-1389
- NPI assigned
- Mar 6, 2019
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 2601002050 | MI | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2601002050 | MI | Yes |
Addresses
Primary practice location
15553 Barber Creek Ave
Kent City, MI 49330-9075
Mailing address
15553 Barber Creek Ave
Kent City, MI 49330-9075
Phone (616) 329-1389
Other providers in Kent City, MI
- Susan Allen
- Lynda Anderson
- Baldwin Family Health Care
- Rebecca Sue Freeland
- Megen Hilbrand
- Melissa Sue Hills
- JS Reister DC PLLC
- Natalie Kok
All providers in Kent City, MI · Athletic Trainer in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.