Provider Demographics
NPI:1700692498
Name:BARTZ, ANNALYSE NICHOLE
Entity type:Individual
Prefix:
First Name:ANNALYSE
Middle Name:NICHOLE
Last Name:BARTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2092 N BAGLEY ST APT 3
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-1552
Mailing Address - Country:US
Mailing Address - Phone:989-590-8897
Mailing Address - Fax:
Practice Address - Street 1:2092 N BAGLEY ST APT 3
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-1552
Practice Address - Country:US
Practice Address - Phone:989-590-8897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide