| Doctor Name: | MARISA ANN HERRERA |
| NPI Number: | 1053586255 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 4704233226 |
| Business Practice Address: | 1035 E Wilcox White Cloud, MI - 49349 |
| Business Phone Number: | 2312689594 |
| Business Fax Number: | 2316891590 |
| Mailing Address: | 1615 Michigan Ave, BALDWIN |
| State: | MI |
| Postal Code: | 493047984 |
| Phone Number: | 2317455045 |
| Fax Number: | 2317455031 |
| NPI Enumeration Date: | 04/28/2008 |
| NPI Last Update Date: | 06/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 4704233226 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |