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Individual

SAMUEL TERRANOVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
770 KENMOOR AVE SE STE 100, GRAND RAPIDS, MI 49546-8602
(616) 272-3533
(616) 259-4839
Mailing address
801 ROSEHILL RD, JACKSON, MI 49202-1762
(517) 212-2008
(517) 212-9023

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
4704356674
MI

Other

Enumeration date
09/04/2025
Last updated
01/20/2026
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