Individual
MARY NOBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
500 MAIN ST, MANISTIQUE, MI 49854-1522
(906) 341-2153
(906) 341-3299
Mailing address
7870W US HIGHWAY 2, MANISTIQUE, MI 49854-8992
(906) 341-2153
(906) 341-3299
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003951
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0G71004
RHC BC NUMBER
MI
Enumeration date
07/07/2006
Last updated
12/19/2013
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