Individual
MINNIE SHINAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1450 LEONARD ST NE, GRAND RAPIDS, MI 49505
(231) 683-3105
Mailing address
1450 LEONARD ST NE, GRAND RAPIDS, MI 49505-5515
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703115465
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164W00000X
—
MI
Enumeration date
07/07/2017
Last updated
07/07/2017
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