Individual provider · Type 1 NPI

Michael David McCallister

Nurse Practitioner · Portage, MI

NPI number 1174185771 Active

Practice location

3770 Glenkerry Ct
Portage, MI 49024-0700

Fax (269) 329-2805

Mailing address

8223 Glenwynd Dr
Kalamazoo, MI 49009-9680

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X4704311437 (MI)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1174185771

Michael David McCallister's National Provider Identifier is 1174185771, issued on Jul 3, 2019. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Portage, MI. The record was last updated on May 5, 2021.