Maureen Elizabeth Hergenreder, RN BA

Individual provider Active NPI Registered Nurse · Kawkawlin, MI

NPI 1578096434 · NPPES record last updated Apr 7, 2017

Key facts

NPI
1578096434
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
4704213066 (MI)
Practice address
1971 8 Mile Rd
Kawkawlin, MI 48631-9779
Phone
(989) 415-8566
NPI assigned
Apr 7, 2017
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
Credentials
Bachelor of Arts, Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704213066MIMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704213066 MI Yes

Addresses

Primary practice location

1971 8 Mile Rd
Kawkawlin, MI 48631-9779

Mailing address

1971 8 Mile Rd
Kawkawlin, MI 48631-9779
Phone (989) 415-8566

Other providers in Kawkawlin, MI

All providers in Kawkawlin, MI · Registered Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.