Provider Demographics
NPI:1619758570
Name:OBERLANDER, AUSTIN MICHAEL (CNA)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:MICHAEL
Last Name:OBERLANDER
Suffix:
Gender:M
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3280 ESSINGHAM ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-9014
Mailing Address - Country:US
Mailing Address - Phone:517-414-6844
Mailing Address - Fax:
Practice Address - Street 1:3280 ESSINGHAM ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-9014
Practice Address - Country:US
Practice Address - Phone:517-414-6844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-06
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0614202291712376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide