Individual
MICKKI RENAE TEMPLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
411 W BROADWAY ST, SUITE A, MOUNT PLEASANT, MI 48858-2402
(989) 772-9523
(989) 772-9052
Mailing address
411 W BROADWAY ST, SUITE A, MT PLEASANT, MI 48858-2446
(989) 772-9523
(989) 772-9052
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704184401
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1010137
MCLAREN HEALTH PLAN
MI
01
—
200000004572
PHP COMMERCIAL
MI
05
—
4520134-11
—
MI
01
—
5008701250
BCBSM
MI
Enumeration date
07/03/2006
Last updated
08/13/2012
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