Jodie Ann Brigham
Individual provider Active NPI Adult Care Home Facility · Edmore, MI
NPI 1891482212 · NPPES record last updated Apr 18, 2023
Key facts
- NPI
- 1891482212
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Care Home Facility 311ZA0620X
- License
- AM590407641 (MI)
- Practice address
- 1380 E Main St
Edmore, MI 48829-8413 - Phone
- (989) 560-9733
- NPI assigned
- Apr 18, 2023
- 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 |
|---|---|---|---|
| AM590407641 | MI | MD | Adult Care Home Facility |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | AM590407641 | MI | Yes |
Addresses
Primary practice location
1380 E Main St
Edmore, MI 48829-8413
Mailing address
11590 Lakeshore Dr
Lakeview, MI 48850-9708
Phone (989) 560-9733
Other providers in Edmore, MI
- Molly Jo Barnes
- Stephanie E Boring
- Countryside Drug Company III
- Jenna Droste
- Edmore Chiropractic Clinic, PLLC
- Edmore Family Dentistry
- Ralph Robert Elsner
All providers in Edmore, MI · Adult Care Home Facility in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2023. 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.