Provider Demographics
NPI:1912150673
Name:STRAUB, RENE ROCHELLE (NP-C)
Entity type:Individual
Prefix:
First Name:RENE
Middle Name:ROCHELLE
Last Name:STRAUB
Suffix:
Gender:
Credentials:NP-C
Other - Prefix:
Other - First Name:RENE
Other - Middle Name:ROCHELLE
Other - Last Name:URBAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:950 VICTORS WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-5217
Mailing Address - Country:US
Mailing Address - Phone:734-926-4800
Mailing Address - Fax:734-973-0595
Practice Address - Street 1:1003 SPRING ST
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2810
Practice Address - Country:US
Practice Address - Phone:231-347-9692
Practice Address - Fax:231-348-1908
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2025-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704200966163W00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIM61830019Medicare PIN