Individual
MIRANDA IACOPELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
145 MICHIGAN ST NE STE 3100, GRAND RAPIDS, MI 49503-2563
(616) 954-9800
Mailing address
5800 FOREMOST DR SE STE 300, GRAND RAPIDS, MI 49546-7062
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704247387
MI
Other
Enumeration date
08/27/2018
Last updated
08/24/2020
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