Individual
DR. TARA ANN BROCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 456-0842
(616) 559-5864
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 456-0842
(616) 559-5864
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
4301114533
MI
2084P0800X
Psychiatry Physician
Primary
4351035205
MI
Other
Enumeration date
04/18/2018
Last updated
02/03/2022
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