Individual
MRS. ANN M AVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
3147 LOGAN VALLEY RD, TRAVERSE CITY, MI 49684-4772
(231) 935-0668
Mailing address
PO BOX 57, CEDAR, MI 49621-0057
(231) 228-5344
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704077842
MI
363LP0200X
Pediatric Nurse Practitioner
4704077842
MI
Other
Enumeration date
04/25/2007
Last updated
11/02/2011
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