Individual
TIMOTHY SCOTT WACKERLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
363 FREMONT ST STE 100, BATTLE CREEK, MI 49017-3395
(269) 969-6100
Mailing address
601 JOHN STREET, BOX 39, KALAMAZOO, MI 49007
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704229024
MI
Other
Enumeration date
08/14/2017
Last updated
03/03/2022
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