Speck, Nicole Marie

Speck, Nicole Marie is an individual health care provider with primary practice located at 2800 Stone School Road Room 112, Ann Arbor MI 48104. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Speck, Nicole Marie can be contacted via phone (734) 973-9367.

Contact Information

Primary practice address
2800 Stone School Road Room 112 Ann Arbor MI 48104
Phone: (734) 973-9367
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4704207836 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 4704207836 Michigan

Profile Details

NPI number 1619978145
LBN Legal business name Speck, Nicole Marie
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2005
Last updated Jan 4th, 2016 - about 8 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 1619978145 NPPES
Michigan Other 50-0-H2-0189-0 BCBS MI NP GROUP
Michigan MEDICAID 77 4631518 BCBS MI NP GROUP

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