| NPI | 1174610406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA EDWARDS Regional Manager 616-774-7005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology |
| Additional Taxonomies | 261QA0005X Clinic/Center, Ambulatory Family Planning Facility |
| 332900000X Non-Pharmacy Dispensing Site | |
| 363AM0700X Physician Assistant, Medical | |
| 207VG0400X Obstetrics & Gynecology, Gynecology | |
| 207V00000X Obstetrics & Gynecology | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2014-02-04 |