Basic Information
| Provider Information | |||||||||
| NPI: | 1093703860 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'HARE | ||||||||
| FirstName: | NANCY | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 LAPEER | ||||||||
| Address2: | |||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486071208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897596464 | ||||||||
| FaxNumber: | 9893998233 | ||||||||
| Practice Location | |||||||||
| Address1: | 3175 W PROFESSIONAL DR | ||||||||
| Address2: | |||||||||
| City: | BAY CITY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 487062823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9896673377 | ||||||||
| FaxNumber: | 9896679991 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2005 | ||||||||
| LastUpdateDate: | 04/09/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | 4704148939 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
ID Information
| ID | Type | State | Issuer | Description | 1002648 | 01 | HEALTH ADVANTAGE PPO | OTHER | 9365130 | 01 | CIGNA PHCS | OTHER | 7380053 | 01 | AETNA | OTHER | 0988156 | 01 | HEALTHPLUS OF MI | OTHER | 1002648 | 01 | MCLAREN HEALTH PLAN | OTHER | 1093703860 | 05 | MI | MEDICAID | 420001344 | 01 | RAILROAD MEDICARE | OTHER | 420G310800 | 01 | BCBS OF MICHIGAN | OTHER | 105570 | 01 | GREAT LAKES HEALTH PLAN | OTHER | 4294795 | 05 | MI | MEDICAID | 209 | 01 | COMMUNITY CHOICE OF MI | OTHER | 381908328 | 01 | UNITED HEALTH CARE | OTHER |