Individual
NATHAN ROUSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.N.P.
Contact information
Practice address
217 S MADISON STREET, TRAVERSE CITY, MI 49684-2320
(231) 922-9270
(231) 922-9271
Mailing address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-5000
(231) 935-6081
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704225508
MI
364SX0200X
Oncology Clinical Nurse Specialist
4704225508
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4952425
—
MI
05
—
4952434
—
MI
Enumeration date
08/13/2006
Last updated
11/12/2024
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