Individual
PAUL DIELEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
1131 IONIA AVE NW, GRAND RAPIDS, MI 49503-1020
(616) 259-7900
(616) 259-7909
Mailing address
1131 IONIA AVE NW, GRAND RAPIDS, MI 49503-1020
(616) 259-7900
(616) 259-7909
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704247208
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704247208
MI
Other
Enumeration date
05/16/2016
Last updated
11/19/2018
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