Individual
BRENT J BAESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGNP-C
Contact information
Practice address
4667 FOX VALLEY DR APT 1B, PORTAGE, MI 49024-8149
(269) 251-4384
Mailing address
4667 FOX VALLEY DR APT 1B, PORTAGE, MI 49024-8149
(269) 251-4384
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
AG03240063
MI
Other
Enumeration date
10/14/2024
Last updated
10/14/2024
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