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Contact Information

COURTNEY L CONVERSE, PA-C
535 S BURDICK ST STE 256
KALAMAZOO, MI49007-6112
 Phone: 269-290-1901
 Fax: 269-290-1913
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for COURTNEY L CONVERSE · (Female)

NPI # 1699743872
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 03/14/2006
Last updated 06/01/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 5601004349
  • MI Medicaid 1699743872
  • MI Other 1417961137 BCBS - BRONSON
Hospital affiliation(s)
  • BRONSON METHODIST HOSPITAL - (Acute Care)
    601 JOHN STREET 42
    KALAMAZOO, MI 49007
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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