Basic Information
| Provider Information | |||||||||
| NPI: | 1467811638 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MASON | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | FREDERICK | ||||||||
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| Credential: | MSN, APN PMHNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3 BYNUM DR | ||||||||
| Address2: | |||||||||
| City: | BATTLE CREEK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490171703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2692754528 | ||||||||
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| Practice Location | |||||||||
| Address1: | 39465 W 14 MILE RD | ||||||||
| Address2: | |||||||||
| City: | NOVI | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483771600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8779069699 | ||||||||
| FaxNumber: | 8884830118 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2016 | ||||||||
| LastUpdateDate: | 01/17/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 4704235099 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.