Individual
KAYLA INNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-3314
(616) 331-5736
Mailing address
301 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-3314
(616) 690-1466
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704293648
MI
Other
Enumeration date
06/23/2020
Last updated
06/23/2020
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