Individual
SUSAN L MASTENBROOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1521 GULL RD, KALAMAZOO, MI 49048-1640
(269) 226-7000
Mailing address
5943 STADIUM DR, KALAMAZOO, MI 49009-3016
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704207644
MI
Other
Enumeration date
04/27/2012
Last updated
12/27/2022
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