Individual
SHANAE BARTLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
50 MAIN ST, COOPERSVILLE, MI 49404
(616) 997-4023
(616) 997-4025
Mailing address
50 MAIN ST, COOPERSVILLE, MI 49404-1231
(616) 997-4023
(616) 997-4025
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F1214708
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OD11075
BCBS
MI
01
—
OD13223
BCBS
MI
Enumeration date
02/13/2015
Last updated
11/15/2019
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