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Individual

MELISSA PILLAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
2122 HEALTH DR SW, WYOMING, MI 49519
(616) 252-7494
(616) 252-7830
Mailing address
5900 BYRON CENTER AVE SW, MEDICAL ADMINISTRATION, GRAND RAPIDS, MI 49504-5617
(616) 252-3243
(616) 252-0260

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704292168
MI
363LF0000X
Family Nurse Practitioner
4704292168
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
D16078473
MI
Enumeration date
03/07/2018
Last updated
08/31/2020
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