KIVA DA-SHAN BAUSWELL

GRAND RAPIDS, MI
NPI1508531088
Former NameKIVA DA-SHAN BAUSWELL-HARRIS
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LG0600X Nurse Practitioner, Gerontology
(Licence: MI  4704291746)
Enumeration Date2021-08-16
Last Update Date2023-05-04
Business Address
KIVA DA-SHAN BAUSWELL A-GNP
145 MICHIGAN ST NE STE 3410
GRAND RAPIDS, MI 49503-2563
Phone number: 616-391-9945
Mailing Address
KIVA DA-SHAN BAUSWELL A-GNP
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 49503-2560
Phone number: 616-486-6790