Individual
LITA ROSE HORST MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
601 JOHN ST, SUITE M-206C, KALAMAZOO, MI 49007-5341
(269) 349-9745
(269) 488-8305
Mailing address
601 JOHN ST STE M-318, KALAMAZOO, MI 49007-5383
(269) 349-9745
(269) 488-8305
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704206770
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5008712490
BCBS
MI
Enumeration date
07/16/2010
Last updated
12/01/2020
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