Individual
MRS. CAROL JANE VANDERGRAAF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4173 EMMA AVE SW, WYOMING, MI 49509-4391
(616) 570-3628
Mailing address
4173 EMMA AVE SW, WYOMING, MI 49509-4391
(616) 570-3628
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704102068
MI
Other
Enumeration date
04/29/2019
Last updated
04/29/2019
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