Jessica Mastbergen
Nurse Practitioner - Adult Health
1221 Sixth St Ste 208
Traverse City
, Michigan 49684-2360
Jessica Mastbergen
Nurse Practitioner - Adult Health
1221 Sixth St Ste 208
Traverse City
, Michigan 49684-2360
(231) 876-6121
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About
Features
Specialties
- Nurse Practitioner - Adult Health
Languages spoken
- English
Location
First Address
- Jessica Mastbergen
- 400 Hobart St
- Cadillac, MI
- Zip : 49601-2331
- Fax : (231) 876-6121
- Phone : (231) 876-6223
Second Address
- Jessica Mastbergen
- 1221 Sixth St Ste 208
- Traverse City, MI
- Zip : 49684-2360
- Fax : (231) 935-0857
- Phone : (231) 935-2045
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LA2200X | Nurse Practitioner - Adult Health | 4704301869 | MI |
National Provider Identifier
| NPI | 1023501699 |
|---|---|
| Provider Name | Jessica Mastbergen |
| First Address | Cadillac, MI 49601-2331 |
| Second Address | Traverse City, MI 49684-2360 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/06/2018 |
| Last Update Date | 08/06/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.