Individual
JEANNINE M BRAKE-NORDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
123 LANSING STREET, CHARLOTTE, MI 48813
(517) 543-2020
(517) 543-0311
Mailing address
123 LANSING STREET, EYE CARE ASSOCIATES OF CHARLOTTE PLLC, CHARLOTTE, MI 48813
(517) 543-2020
(517) 543-0311
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003751
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2200102
PHP OF MID MICHIGAN
MI
01
—
410029431
RAILROAD MEDICARE
—
01
—
JB003751
BCBS OF MI
MI
Enumeration date
07/03/2006
Last updated
06/22/2010
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