Individual
MS. JANE BOSTROM MAUGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1490 E BELTLINE AVE SE, GRAND RAPIDS, MI 49506-4336
(616) 940-0040
Mailing address
1325 THORNAPPLE RIVER DR SE, GRAND RAPIDS, MI 49546-9736
(616) 676-0208
(253) 679-0208
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704124206
MI
Other
Enumeration date
06/26/2007
Last updated
07/08/2007
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