Provider Demographics
NPI:1033654702
Name:WALIGORSKI, JANE SUSAN (FNP-BC, PMHNP-C)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:SUSAN
Last Name:WALIGORSKI
Suffix:
Gender:
Credentials:FNP-BC, PMHNP-C
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:SUSAN
Other - Last Name:WEINGARTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5380 HUNTERS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:IMLAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48444-9711
Mailing Address - Country:US
Mailing Address - Phone:810-338-3508
Mailing Address - Fax:
Practice Address - Street 1:1375 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-1350
Practice Address - Country:US
Practice Address - Phone:810-667-5701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-04
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704232878363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily