Provider Demographics
NPI:1174194377
Name:HAAPAPURO, CARA LYNN (NP)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:LYNN
Last Name:HAAPAPURO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1548 WOIDERSKI RD
Mailing Address - Street 2:
Mailing Address - City:CHEBOYGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49721-9176
Mailing Address - Country:US
Mailing Address - Phone:231-420-4047
Mailing Address - Fax:
Practice Address - Street 1:920 S HURON ST
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721-2267
Practice Address - Country:US
Practice Address - Phone:906-643-8585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704296940363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704296940OtherNURSE PRACTITIONER LICENSE