Provider Demographics
NPI:1477095594
Name:FROST, JONI (NP)
Entity Type:Individual
Prefix:
First Name:JONI
Middle Name:
Last Name:FROST
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2585 SPRING ARBOR RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-3655
Mailing Address - Country:US
Mailing Address - Phone:517-205-1285
Mailing Address - Fax:517-205-0115
Practice Address - Street 1:2585 SPRING ARBOR RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-3655
Practice Address - Country:US
Practice Address - Phone:517-205-1285
Practice Address - Fax:517-205-0115
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704284987363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner