Northridge Family Practice LLC
NPI 1891712493ActiveOrganization· Nurse Practitioner· Hale, MI
Nurse Practitioner in Hale, Michigan, registered in NPPES in July 2006. The authorized official on file is Debra Kaye Provoast, RN MSN FNP, Managing Officer.
Overview
| NPI | 1891712493 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 17, 2006 |
| Last updated in NPPES | Nov 2, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 4704173663 | MI |
| Internal Medicine | 207R00000X | 4301061417 | MI |
| Nurse Practitioner | 363L00000X | 4704148660 | MI |
| Nurse Practitioner, Family | 363LF0000X | 4704245250 | MI |
| Nurse Practitioner, Family | 363LF0000X | 4704283185 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Nurse Practitioner providers in Hale
- 1770397788
- 1740686534