Provider Demographics
NPI:1184477978
Name:LARGENT, MARIAH JEAN
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:JEAN
Last Name:LARGENT
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 1:413 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:PINCONNING
Mailing Address - State:MI
Mailing Address - Zip Code:48650-9507
Mailing Address - Country:US
Mailing Address - Phone:989-305-8075
Mailing Address - Fax:
Practice Address - Street 1:413 W 4TH ST
Practice Address - Street 2:
Practice Address - City:PINCONNING
Practice Address - State:MI
Practice Address - Zip Code:48650-9507
Practice Address - Country:US
Practice Address - Phone:989-305-8075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula