Individual
SUSAN RUTH BRANON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3097 PRAIRIE ST SW, GRANDVILLE, MI 49418-2000
(616) 531-9973
Mailing address
3097 PRAIRIE ST SW, GRANDVILLE, MI 49418-2000
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703026816
MI
Other
Enumeration date
02/03/2020
Last updated
02/03/2020
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