Individual
SUE ANN HAFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
415 W WACKERLY ST, SUITE C, MIDLAND, MI 48640-2761
(989) 837-6505
(989) 835-8428
Mailing address
415 W WACKERLY ST, MIDLAND, MI 48640-2761
(989) 837-6505
(989) 835-8428
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
4704096364
MI
363LF0000X
Family Nurse Practitioner
Primary
4704096364
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4869285-10
—
MI
01
—
5008762560
BCBSM
MI
Enumeration date
05/26/2006
Last updated
07/09/2008
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