Provider Demographics
NPI:1700663200
Name:BAREMAN, SOMER L (NP)
Entity Type:Individual
Prefix:
First Name:SOMER
Middle Name:L
Last Name:BAREMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9350 PIER PL
Mailing Address - Street 2:
Mailing Address - City:WEST OLIVE
Mailing Address - State:MI
Mailing Address - Zip Code:49460-8428
Mailing Address - Country:US
Mailing Address - Phone:616-403-1665
Mailing Address - Fax:
Practice Address - Street 1:6401 PRAIRIE ST STE 2100
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49444-7842
Practice Address - Country:US
Practice Address - Phone:231-672-2112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704280257NSA2204K363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily