Individual
JACOB SCOTT WELLNITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
1140 N STATE ST, SAINT IGNACE, MI 49781-1048
(906) 643-0466
(906) 643-0414
Mailing address
2890 BURTCH RD, GRASS LAKE, MI 49240-9416
(906) 430-7448
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704311384
MI
Other
Enumeration date
02/07/2020
Last updated
03/17/2025
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