Individual
GRANT KEITH HEIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, FNP
Contact information
Practice address
1009 W GREEN ST, HASTINGS, MI 49058-1710
(269) 945-1212
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704322335NSA210E9
MI
Other
Enumeration date
06/15/2021
Last updated
10/06/2021
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