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1821836024
JACOB RUSSELL BRYDE
EAST LANSING, MI
NPI
1821836024
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LG0600X Nurse Practitioner, Gerontology
(Licence: MI 4704335991)
Enumeration Date
2024-07-20
Last Update Date
2024-10-15
Business Address
JACOB RUSSELL BRYDE DNP, AGPCNP-BC
804 SERVICE RD STE A110
EAST LANSING, MI 48824-7015
Phone number: 517-353-2822
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Mailing Address
JACOB RUSSELL BRYDE DNP, AGPCNP-BC
804 SERVICE RD STE A202
EAST LANSING, MI 48824-7015
Phone number: 517-355-2822
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