Individual
ENA OSTERHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 MICHIGAN ST NE, SUITE 8830, GRAND RAPIDS, MI 49503-2560
(616) 459-7258
(616) 459-5215
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
PA9112866
FL
Other
Enumeration date
07/17/2015
Last updated
02/04/2020
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