Jacob D Chard

Individual provider Active NPI Registered Nurse · Manistee, MI

NPI 1538716618 · NPPES record last updated Aug 22, 2019

Key facts

NPI
1538716618
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
4704280227 (MI)
Practice address
2198 US 31 S
Manistee, MI 49660-9618
Phone
(877) 398-2013
NPI assigned
Aug 22, 2019
Sex
Male
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
4704280227MIMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704280227 MI Yes

Addresses

Primary practice location

2198 US 31 S
Manistee, MI 49660-9618

Mailing address

310 Glocheski Dr
Manistee, MI 49660-2639
Phone (231) 309-1712

Other providers in Manistee, MI

All providers in Manistee, MI · Registered Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.