Richard Brodbeck

Individual provider Active NPI General Practice Registered Nurse · Pinckney, MI

NPI 1609472240 · NPPES record last updated Dec 9, 2020

Key facts

NPI
1609472240
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Registered Nurse 163WG0000X
License
4704196726 (MI)
Practice address
8247 Pawnee TRL
Pinckney, MI 48169-9396
Phone
(810) 819-6222
NPI assigned
Dec 9, 2020
Sex
Male
Sole proprietor
Yes

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
4704196726MIMDGeneral Practice Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 4704196726 MI Yes

Addresses

Primary practice location

8247 Pawnee TRL
Pinckney, MI 48169-9396

Mailing address

8247 Pawnee TRL
Pinckney, MI 48169-9396
Phone (810) 819-6222

Other providers in Pinckney, MI

All providers in Pinckney, MI · General Practice Registered Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.