Provider Demographics
NPI:1447500715
Name:FEYERS, GINA MARIA (FNP)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:MARIA
Last Name:FEYERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35680 JEFFERSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:HARRISON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48045
Mailing Address - Country:US
Mailing Address - Phone:586-741-0541
Mailing Address - Fax:
Practice Address - Street 1:33021 GARFIELD ROAD
Practice Address - Street 2:SUITE #8091 MINUTECLINIC
Practice Address - City:FRASER
Practice Address - State:MI
Practice Address - Zip Code:48026-1800
Practice Address - Country:US
Practice Address - Phone:586-293-5012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704216773363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily