Individual
MARY ANNE PUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1480 W CENTER RD, SUITE 5, ESSEXVILLE, MI 48732-2143
(989) 894-4625
(989) 494-4626
Mailing address
401 S BALLENGER HWY, FLINT, MI 48532-3638
(810) 342-1000
(810) 342-1590
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704098741
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1011985
MCLAREN HEALTH PLAN
MI
05
—
4579356
—
MI
01
—
5008702430
BLUE CROSS BLUE SHIELD
MI
01
—
METRAHEALTH
P00213438CN5519
MI
Enumeration date
01/23/2007
Last updated
07/09/2007
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