Mary M. Stuner, CFNP, P.C.
Organization Active NPI Nurse Practitioner · Vestaburg, MI
NPI 1801068341 · NPPES record last updated Mar 31, 2020
Key facts
- NPI
- 1801068341
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 4704145370 (MI)
- Legal business name
- MARY M. STUNER, CFNP, P.C.
- Practice address
- 11116 Pine Grove Road
Suite B
Vestaburg, MI 48891 - Phone
- (989) 268-1337
- Fax
- (989) 268-5452
- NPI assigned
- Mar 25, 2008
- Organization subpart
- No
Authorized official
- Name
- Mary Margaret Stuner, CFNP
- Title
- Business Owner
- Phone
- (989) 268-1337
Practitioners 1
-
Mary Margaret Stuner, CFNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D1043028 | Mary M Stuner, CFNP, PC | Certificate of waiver | Jan 4, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090826000575 | MI | Part B Supplier - Clinic/Group Practice | 1153476239 |
Receives reassigned benefits from 1 practitioner Practice locations: Vestaburg, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner |
363L00000X | 4704145370 | MI | Yes |
Addresses
Primary practice location
11116 Pine Grove Road
Suite B
Vestaburg, MI 48891
Mailing address
11116 N Pine Grove Rd Ste B
Vestaburg, MI 48891-9516
Phone (989) 268-1337
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4310629 | Medicaid | MI |
Other names
- North Mission Healthcare
Other providers in Vestaburg, MI
- Jodie Diehl
- Ryalee Kristan Dove
- Marie Jerome
- Mymichigan Medical Center Alma
- Mymichigan Medical Center Alma
- Julie Nobach
- Samantha Reikowski
- Michelle Lee Richard-Whitman
All providers in Vestaburg, 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 Mar 31, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.