DEBRA K PROVOAST NP
NPI 1033107271
Nurse Practitioner - Family in Hale, MI

Active since October 12, 2005
3190 NORTHRIDGE DRIVE, HALE, MI 48739(989) 728-6000(989) 728-6003 Get Directions Write a Review

NPPES record last updated: March 24, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Debra K Provoast Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEBRA K PROVOAST NP (NPI 1033107271) is an individual family provider in Hale, Michigan, licensed in Michigan (4704173663) and active in the NPI registry since October 2005.

NPPES Registry Identity

NPI1033107271
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameDEBRA K PROVOASTCredential: NP
Location Address3190 NORTHRIDGE DRIVEHale, MI 48739-9276
Mailing AddressPo Box 279Hale, MI 48739-0279 · (989) 728-6000 · Fax (989) 728-6003
Fax(989) 728-6003
Sole ProprietorNo
Enumeration DateOctober 12, 2005
Last NPPES UpdateMarch 24, 2014
NPI 1033107271 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in MI · 4704173663
3190 NORTHRIDGE DRIVE, Hale, MI 48739

Other Identifiers 5

Medicare UPINS92769
Other500C510200MI · Bcbs
Medicare PIN0P24490MI
OtherDP173663MI · License
Medicaid105235126MI

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
3190 NORTHRIDGE DRIVE
HALE, MI 48739
Internal Medicine (Clinical Cardiac Electrophysiology)
3190 NORTHRIDGE DRIVE
HALE, MI 48739
Nurse Practitioner
3190 NORTHRIDGE DRIVE
HALE, MI 48739

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Debra Provoast's NPI number?

The NPI number for Debra Provoast is 1033107271. It was assigned to this individual provider in the NPPES registry on October 12, 2005.

Where is Debra Provoast located?

Debra Provoast practices at 3190 Northridge Drive, Hale, MI 48739. The listed phone number is (989) 728-6000.

What is Debra Provoast's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Debra Provoast was last updated on March 24, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.