Individual
DEBRA SUE DEGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
664 MICHIGAN AVE, HOLLAND, MI 49423-4944
(616) 392-5973
(616) 392-1646
Mailing address
664 MICHIGAN AVE, HOLLAND, MI 49423-4944
(616) 392-5973
(616) 392-1646
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
4704132616
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0876976
BCBSM IND. PIN
MI
01
—
0G01201
MEDICARE GRP PIN
MI
01
—
420G012010
BCBSM GRP PIN
MI
01
—
DF4619
MEDICARE RR GRP PIN
MI
Enumeration date
09/27/2006
Last updated
02/02/2021
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