Individual
AUBREY ELIZABETH DEWILDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
145 MICHIGAN ST NE STE 3410, GRAND RAPIDS, MI 49503-2563
(616) 391-9945
Mailing address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704307498
MI
Other
Enumeration date
05/02/2019
Last updated
11/24/2021
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