Individual
SUSAN GRACE PASSAVANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
221 MICHIGAN ST NE STE 400, GRAND RAPIDS, MI 49503-2543
(616) 486-9600
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704280442
MI
Other
Enumeration date
05/18/2015
Last updated
06/26/2019
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