Basic Information
| Provider Information | |||||||||
| NPI: | 1164997235 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BREMER | ||||||||
| FirstName: | DANIELLE | ||||||||
| MiddleName: | CLARICE | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3175 PROFESSIONAL CT | ||||||||
| Address2: | |||||||||
| City: | BAY CITY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 487062823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9896673377 | ||||||||
| FaxNumber: | 9896679991 | ||||||||
| Practice Location | |||||||||
| Address1: | 3175 PROFESSIONAL CT | ||||||||
| Address2: | |||||||||
| City: | BAY CITY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 487062823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9896673377 | ||||||||
| FaxNumber: | 9896679991 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2018 | ||||||||
| LastUpdateDate: | 01/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 4704310782 | MI | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 367A00000X | 4704310782 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.