Provider Demographics
NPI:1568084440
Name:PRINGLE, ANNETTE MARIE
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:MARIE
Last Name:PRINGLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19275 DOYLE RD
Mailing Address - Street 2:
Mailing Address - City:GREGORY
Mailing Address - State:MI
Mailing Address - Zip Code:48137-9405
Mailing Address - Country:US
Mailing Address - Phone:734-498-2601
Mailing Address - Fax:734-498-2601
Practice Address - Street 1:19251 DOYLE RD
Practice Address - Street 2:
Practice Address - City:GREGORY
Practice Address - State:MI
Practice Address - Zip Code:48137-9405
Practice Address - Country:US
Practice Address - Phone:734-498-2277
Practice Address - Fax:734-498-2601
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator