Provider Demographics
NPI:1427447895
Name:BUDEK, DOROTHEA (FNP-BC)
Entity type:Individual
Prefix:
First Name:DOROTHEA
Middle Name:
Last Name:BUDEK
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N5241 US HWY 45
Mailing Address - Street 2:
Mailing Address - City:WATERSMEET
Mailing Address - State:MI
Mailing Address - Zip Code:49969-0009
Mailing Address - Country:US
Mailing Address - Phone:906-358-4588
Mailing Address - Fax:
Practice Address - Street 1:N5241 US HWY 45
Practice Address - Street 2:
Practice Address - City:WATERSMEET
Practice Address - State:MI
Practice Address - Zip Code:49969-0009
Practice Address - Country:US
Practice Address - Phone:906-358-4588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-22
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6219-33363LF0000X
MI4704267422363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily