Individual
KATHLEEN BULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
730 GRANDVILLE AVE SW, GRAND RAPIDS, MI 49503-4920
(616) 913-8400
(616) 742-1322
Mailing address
245 STATE ST SE, GRAND RAPIDS, MI 49503-4328
(616) 913-1808
(616) 913-1818
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704096205
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4636819
—
MI
05
—
4925188
—
MI
Enumeration date
08/07/2006
Last updated
07/08/2007
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