Individual
MR. ALAN L NIEBOER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
GNP
Contact information
Practice address
204 W MAIN ST, FREMONT, MI 49412-1181
(231) 924-1800
(231) 924-1810
Mailing address
212 S SULLIVAN AVE, FREMONT, MI 49412-1548
(231) 924-3300
(231) 924-1320
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
4704120574
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4383367
—
MI
Enumeration date
08/27/2006
Last updated
12/11/2009
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