Individual
JILL ANN LAFORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
145 MICHIGAN ST NE STE 3410, GRAND RAPIDS, MI 49503-2563
(616) 391-9945
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
4704159260
MI
Other
Enumeration date
12/07/2022
Last updated
02/24/2023
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