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Export Provider Record NPI 1043704133
Cora J PavlikFNP
Active
NPI Number1043704133
NPI TypeNPI-1 Individual
SpecialtyNurse Practitioner, Family
Provider Details
NPI1043704133
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2018-06-21
Last Updated2018-06-21
Mailing Address4000 Wellness Dr Christie Building
Midland, MI 48670-2000
United States
Phone: (989) 875-5111
📍 View Map
Primary Practice Address121 N Pine River St
Ithaca, MI 48847-1039
United States
Phone: (989) 875-5111 | Fax: (989) 875-5023
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes363LF0000X – Nurse Practitioner, FamilyMI4704313679
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About NPI 1043704133

Cora J Pavlik FNP is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1043704133. The primary specialty listed is Nurse Practitioner, Family. The provider is located in Ithaca, MI. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2018-06-21. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1043704133?

NPI 1043704133 belongs to Cora J Pavlik FNP, a Nurse Practitioner, Family in Ithaca, MI. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1043704133 active?

The current status of NPI 1043704133 in the NPPES registry is Active. The record was last updated on 2018-06-21.

What specialty is NPI 1043704133?

NPI 1043704133 is classified under the taxonomy Nurse Practitioner, Family. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1043704133?

You can verify NPI 1043704133 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1043704133?

The primary practice address on file for NPI 1043704133 is 121 N Pine River St, Ithaca, MI 48847-1039. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1043704133 issued?

NPI 1043704133 was first issued (enumerated) on 2018-06-21. The NPPES record was last updated on 2018-06-21.

Practice Location Map

Cora J Pavlik is located at 121 N Pine River St, Ithaca, MI. Use the map below to find directions or verify the practice location.

📍 121 N Pine River St, Ithaca, MI 48847-1039  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Cora J Pavlik. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1043704133. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Nurse Practitioner, Family4704313679MI
Data Verified from CMS NPPES Last synced: 2026-06-18 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162