Individual
LORIELLEN MARIE CONVERSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CNP
Contact information
Practice address
970 PARCHMENT DRIVE SE, SUITE 203, GRAND RAPIDS, MI 49546-8302
(616) 949-4840
(616) 949-3531
Mailing address
970 PARCHMENT DRIVE SE, SUITE 203, GRAND RAPIDS, MI 49546-8302
(616) 949-4840
(616) 949-3531
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704194357
MI
Other
Enumeration date
08/16/2007
Last updated
08/27/2007
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