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1730795485
ELYSE C VAN ITTERSUM
TROY, MI
NPI
1730795485
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Former Name
ELYSE C REXER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MI 4704341270)
Enumeration Date
2020-09-18
Last Update Date
2023-04-06
Business Address
Ms. ELYSE C VAN ITTERSUM FNP-C
4060 ROCHESTER RD
TROY, MI 48085-4923
Phone number: 248-250-6420
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Mailing Address
Ms. ELYSE C VAN ITTERSUM FNP-C
6058 HEARTHSIDE DR
TROY, MI 48098-5363
Phone number: 248-765-6535
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