Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 4704156681 | MI |
N | 363LP2300X | Nurse Practitioner - Primary Care | 4704156681 | MI |
NPI | 1023067113 |
---|---|
Provider Name | Carla A Behling |
First Address | Sault Sainte Marie, MI 49783 |
Second Address | Sault Sainte Marie, MI 49783 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 01/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3457789 | (05) | MI |
500A710160 | BCBS (01) | MI |
P23876 | (02) |