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Individual

BILLIE SUE BERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
2310 E MICHIGAN AVE, LANSING, MI 48912-4018
(517) 346-7628
(517) 346-7629
Mailing address
6440 LAKE DR, HASLETT, MI 48840-8989
(517) 339-1997

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704097959
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0853310215
BLUE SHIELD PROVIDER NO
MI
01
4704097959
STATE LICENSE
MI
Enumeration date
12/27/2006
Last updated
07/09/2007
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