Organization
DICKINSON COUNTY HEALTHCARE SYSTEM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI MARTIN (INSURANCE CREDENTIALING SPECIALIST)
(906) 776-5705
Entity
Organization
Contact information
Practice address
1721 S STEPHENSON AVE, IRON MOUNTAIN, MI 49801-3637
(906) 774-1313
(906) 776-5639
Mailing address
PO BOX 549, IRON MOUNTAIN, MI 49801-0549
(906) 774-1313
(906) 776-5639
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704233146
MI
Other
Enumeration date
08/29/2014
Last updated
08/29/2014
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