Individual
ELAINE JOY-PETERSON MALONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
550 MUNSON AVE, TRAVERSE CITY, MI 49686-3580
(231) 935-8540
(231) 935-8544
Mailing address
550 MUNSON AVE, TRAVERSE CITY, MI 49686-3580
(231) 935-8540
(231) 935-8544
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704159600
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104307472
—
MI
01
—
EL159600
BLUE CROSS
MI
Enumeration date
10/26/2006
Last updated
01/15/2014
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