Provider Demographics
NPI:1548859143
Name:JPP MANAGEMENT OF NEGAUNEE LLC
Entity type:Organization
Organization Name:JPP MANAGEMENT OF NEGAUNEE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIX
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:906-361-3154
Mailing Address - Street 1:263 W. WATER STREET
Mailing Address - Street 2:
Mailing Address - City:NEGAUNEE
Mailing Address - State:MI
Mailing Address - Zip Code:49866
Mailing Address - Country:US
Mailing Address - Phone:906-361-3154
Mailing Address - Fax:
Practice Address - Street 1:1000 COUNTRY LN STE 300
Practice Address - Street 2:
Practice Address - City:ISHPEMING
Practice Address - State:MI
Practice Address - Zip Code:49849-3408
Practice Address - Country:US
Practice Address - Phone:906-361-3154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care