Individual
RHONDA JANIECE IVAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP NURSE PRACTITIONE
Contact information
Practice address
5400 MACKINAW RD, STE 6100, SAGINAW, MI 48604-9515
(989) 792-3100
(989) 792-9860
Mailing address
5400 MACKINAW RD, STE 6100, SAGINAW, MI 48604-9515
(989) 792-3100
(989) 792-9860
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704135668
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4223256
—
MI
Enumeration date
01/04/2006
Last updated
07/08/2007
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