Basic Information
| Provider Information | |||||||||
| NPI: | 1083113757 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HERSHBERGER | ||||||||
| FirstName: | LILY | ||||||||
| MiddleName: | MICHELLE | ||||||||
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| Credential: | MSN, CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6789 N 35TH ST | ||||||||
| Address2: | |||||||||
| City: | RICHLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490839626 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2694198980 | ||||||||
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| Practice Location | |||||||||
| Address1: | 601 JOHN ST STE N1200 | ||||||||
| Address2: | |||||||||
| City: | KALAMAZOO | ||||||||
| State: | MI | ||||||||
| PostalCode: | 49007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2693417979 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2018 | ||||||||
| LastUpdateDate: | 10/12/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.