Individual
MARYLEE PAKIESER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4020 COPPER VW STE 104, TRAVERSE CITY, MI 49684-7041
(231) 421-6921
Mailing address
3785 BAY RD, SAGINAW, MI 48603-2433
(989) 791-2455
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704106641
MI
363LG0600X
Gerontology Nurse Practitioner
4704106641
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104390272
—
MI
01
—
MP106641
BLUE CROSS
MI
Enumeration date
10/26/2006
Last updated
11/19/2025
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