Provider Demographics
NPI:1528048212
Name:RITCHARD, MARIE A (NP)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:A
Last Name:RITCHARD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1848
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49443-1848
Mailing Address - Country:US
Mailing Address - Phone:231-672-6700
Mailing Address - Fax:231-672-6749
Practice Address - Street 1:3570 HENRY ST STE 220
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49441-4576
Practice Address - Country:US
Practice Address - Phone:231-672-6700
Practice Address - Fax:231-672-4825
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704114501363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4476887Medicaid
MIS99616Medicare UPIN