Mary Margaret Fedewa, CRNP CNS
Individual provider Active NPI Nurse Practitioner · Dewitt, MI
NPI 1659624138 · NPPES record last updated Oct 20, 2012
Key facts
- NPI
- 1659624138
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 4704149241 (MI)
- Practice address
- 3263 W Chadwick Rd
Dewitt, MI 48820-9194 - Phone
- (517) 899-0816
- NPI assigned
- Oct 20, 2012
- Sex
- Female
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 4704149241 | MI | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704149241 | MI | Yes |
| Nurse Practitioner | 363L00000X | 15347 | CA | |
| Clinical Nurse Specialist | 364S00000X | 2258 | CA |
Addresses
Primary practice location
3263 W Chadwick Rd
Dewitt, MI 48820-9194
Mailing address
Nih 10 Center Dr
Bethesda, MD 20894-0001
Other providers in Dewitt, MI
- Julia Drake
- Jackie Drushel-Vanamburg
- Larson Pax Drzewicki
- Edward W. Sparrow Hospital Association
- David Joseph Fedewa
- Jana Marie Fisher
- Emily Anne Fritz
- Jaren Marie Pickens Gebhard
- Jason Michael Gilliam
- Kaylea Sayle Goerge-Flowers
All providers in Dewitt, MI · Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2012. 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.