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1811612690
CIENNA RENEE LODGE
GRAND RAPIDS, MI
NPI
1811612690
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LG0600X Nurse Practitioner, Gerontology
(Licence: MI 4704338438)
Enumeration Date
2022-10-05
Last Update Date
2023-01-30
Business Address
CIENNA RENEE LODGE NP
100 MICHIGAN ST NE # MC019
GRAND RAPIDS, MI 49503-2560
Phone number: 616-486-0310
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Mailing Address
CIENNA RENEE LODGE NP
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 49503-2560
Phone number:
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