Provider Demographics
NPI:1467440214
Name:NERRETER, KATHERINE MARI (CNM)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARI
Last Name:NERRETER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:501 LAPEER AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48607-1208
Mailing Address - Country:US
Mailing Address - Phone:989-759-6400
Mailing Address - Fax:989-759-6423
Practice Address - Street 1:3175 PROFESSIONAL DRIVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-2823
Practice Address - Country:US
Practice Address - Phone:989-667-3377
Practice Address - Fax:989-667-9991
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704120873367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
141768OtherGREAT LAKES HEALTH PLAN
P00025443OtherRAILROAD MEDICARE
1009318OtherHEALTH ADVANTAGE PPO
381908328OtherTRICARE
MI420N310800OtherBCBS
1009318OtherMCLAREN HEALTH PLAN
MI4527251OtherMOLINA HEALTH CARE
MI055OtherCOMMUNITY CHOICE
MI0996207OtherHEALTHPLUS
MI4527251Medicaid
7120498OtherAETNA
9365447OtherCIGNA
P00025443OtherRAILROAD MEDICARE
P24043Medicare UPIN