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1285349464
CARISSA JOHANNA VANDERWOUDE
GRAND RAPIDS, MI
NPI
1285349464
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MI 4704335926)
Enumeration Date
2023-01-23
Last Update Date
2023-04-21
Business Address
CARISSA JOHANNA VANDERWOUDE FNP
1900 WEALTHY ST SE STE 200
GRAND RAPIDS, MI 49506-2969
Phone number: 616-774-0276
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Mailing Address
CARISSA JOHANNA VANDERWOUDE FNP
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 49503-2560
Phone number: 616-486-6790
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