Individual
HEATHER LYNN DIEKEVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
109 MICHIGAN ST NW, GRAND RAPIDS, MI 49503-3792
(616) 200-8435
Mailing address
109 MICHIGAN ST NW, GRAND RAPIDS, MI 49503-3792
(616) 200-8435
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704340948
MI
Other
Enumeration date
12/11/2023
Last updated
12/11/2023
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