Provider Demographics
NPI:1356596464
Name:HEALTHY PATHS
Entity type:Organization
Organization Name:HEALTHY PATHS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LOYNES
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:269-372-6038
Mailing Address - Street 1:8210 KEWEENAW ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-5957
Mailing Address - Country:US
Mailing Address - Phone:269-372-6038
Mailing Address - Fax:
Practice Address - Street 1:8210 KEWEENAW ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-5957
Practice Address - Country:US
Practice Address - Phone:269-372-6038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704142535251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1588661987OtherNPI PERSONAL