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1255444931
TERESA K FATUM
GRAND RAPIDS, MI
NPI
1255444931
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Former Name
TERESA K SHANK
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: MI 4704170665)
Enumeration Date
2006-08-16
Last Update Date
2014-07-03
Business Address
Ms. TERESA K FATUM CRNA
3333 EVERGREEN DR NE
GRAND RAPIDS, MI 49525-9756
Phone number: 616-364-4200
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Mailing Address
Ms. TERESA K FATUM CRNA
3333 EVERGREEN DR NE
GRAND RAPIDS, MI 49525-9756
Phone number: 616-364-4200
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