Individual
MISS MICHELLE J ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.F.N.P.
Contact information
Practice address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7272
(616) 361-5828
Mailing address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7272
(616) 361-5828
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704217093
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639253784
—
MI
05
—
4466209
—
MI
Enumeration date
06/30/2006
Last updated
04/05/2021
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