Organization
MID-MICHIGAN NEUROLOGY CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KANDI LINN PRESTON (BILLING SPECIALIST)
(989) 463-0957
Entity
Organization
Contact information
Practice address
4595 JENNIFER LN, MT PLEASANT, MI 48858-2064
(989) 772-0453
(989) 773-2538
Mailing address
4595 JENNIFER LN, MT PLEASANT, MI 48858-2064
(989) 772-0453
(989) 773-2538
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
MI
363A00000X
Physician Assistant
—
MI
363L00000X
Nurse Practitioner
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130C700220
BCBSM
MI
01
—
500C700210
BCBSM
MI
Enumeration date
11/10/2009
Last updated
06/06/2019
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