Borgeson-Gray, Brooke Alice

Borgeson-Gray, Brooke Alice is an individual health care provider with primary practice located at 3147 Logan Valley Rd , Traverse City MI 49684-4772. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Community Health, which is considered as her primary health care specialty. Borgeson-Gray, Brooke Alice can be contacted via phone (231) 929-3111.

Contact Information

Primary practice address
3147 Logan Valley Rd Traverse City MI 49684-4772
Phone: (231) 929-3111
Fax: (231) 946-0445
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Community Health 363LC1500X 4704124111 Michigan

Profile Details

NPI number 1447430236
LBN Legal business name Borgeson-Gray, Brooke Alice
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2007
Last updated Jul 22nd, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447430236 NPPES
Michigan MEDICAID 1447430236

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