Jay Petroski
Individual provider Active NPI Community Health Worker · Iron River, MI
NPI 1922817873 · NPPES record last updated Jan 6, 2025
Key facts
- NPI
- 1922817873
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- Practice address
- 703 N 2ND Ave
Iron River, MI 49935-1451 - Phone
- (906) 265-5126
- NPI assigned
- Jan 6, 2025
- Sex
- Male
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Yes |
Addresses
Primary practice location
703 N 2ND Ave
Iron River, MI 49935-1451
Mailing address
715 Pyle Dr
Kingsford, MI 49802-4456
Other providers in Iron River, MI
- Anna Jane Oosterbaan
- Karen Elaine Paddock
- Erin Pairolero
- Tara Lynn Parent
- Barbara J Peterson
- Brenda Jo Plociniak
- Deborah Lyn Polzin
- Kelly Polzin
- Alyssa Possanza
- Nicki Lee Price
All providers in Iron River, MI · Community Health Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2025. 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.