Dunham, Sue Ellen
Dunham, Sue Ellen is an sole proprietor health care provider with primary practice located at 4020 Copper Vw Ste 104 , Traverse City MI 49684. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Dunham, Sue Ellen can be contacted via phone (231) 421-6921.Contact Information
Primary practice address
4020 Copper Vw Ste 104
Traverse City MI 49684
Phone: (231) 421-6921
Fax: (231) 421-7852
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 4704082241 | Michigan |
Profile Details
| NPI number | 1427068790 |
|---|---|
| LBN Legal business name | Dunham, Sue Ellen |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 9th, 2006 |
| Last updated | Apr 17th, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427068790 | NPPES |
| Michigan | MEDICAID | 4945609-10 | |
| Michigan | Other | 5008770670 |
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