Jessica Brooke Huntzinger, RN

Individual provider Active NPI Registered Nurse · Ontonagon, MI

NPI 1376196667 · NPPES record last updated Jul 17, 2019

Key facts

NPI
1376196667
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
4704265639 (MI)
Practice address
515 Quartz St
Ontonagon, MI 49953-1115
Phone
(906) 884-4804
Fax
(906) 884-4856
NPI assigned
Jul 17, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704265639MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Copper Country Community Mental Health Services Past
since Jul 25, 2019
Accepting new patients
Copper Country Community Mental Health Services Past
since Jul 25, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704265639 MI Yes

Addresses

Primary practice location

515 Quartz St
Ontonagon, MI 49953-1115

Mailing address

105 3Rd St
Ontonagon, MI 49953-1350

Other providers in Ontonagon, MI

All providers in Ontonagon, MI · Registered Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.