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1669259099
NICOLE KRISTINE DIVITA
GRAND RAPIDS, MI
NPI
1669259099
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2023-09-11
Last Update Date
2023-09-11
Business Address
NICOLE KRISTINE DIVITA
1115 BALL AVE NE
GRAND RAPIDS, MI 49505-5904
Phone number: 616-456-6571
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Mailing Address
NICOLE KRISTINE DIVITA
1032 HOYT ST SE
GRAND RAPIDS, MI 49507-3717
Phone number:
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