Provider Demographics
NPI:1063416972
Name:HARING, NANETTE MARIE (NP)
Entity type:Individual
Prefix:MS
First Name:NANETTE
Middle Name:MARIE
Last Name:HARING
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:222 N KALAMAZOO MALL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-3881
Mailing Address - Country:US
Mailing Address - Phone:269-345-0273
Mailing Address - Fax:269-345-8522
Practice Address - Street 1:222 N KALAMAZOO MALL
Practice Address - Street 2:SUITE 100
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-3881
Practice Address - Country:US
Practice Address - Phone:269-345-0273
Practice Address - Fax:269-345-8522
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2023-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704154258363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4518010Medicaid
MI1063416972Medicaid
MI500C912770OtherBCBSM
MI4518010Medicaid