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Individual

MS. NICOLE A HERING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
600 HEALTH PARK BLVD, SUITE G, GRAND BLANC, MI 48439-2558
(810) 606-6444
Mailing address
3495 S CENTER RD, BURTON, MI 48519-1455
(810) 424-2011
(810) 249-4037

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601005787
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1295023547
MHP GROUP NPI
MI
01
700H273300
BCBSM GROUP PIN MHP
MI
01
MI4989
MHP MEDICARE GROUP PIN
MI
Enumeration date
07/07/2010
Last updated
08/15/2014
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