Individual
SHANNON GEROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3124 N WELLNESS DR STE 10, HOLLAND, MI 49424-8121
(616) 738-5870
Mailing address
3124 N WELLNESS DR STE 10, HOLLAND, MI 49424-8121
(616) 738-5870
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704353282
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704353282
LICENSE
MI
Enumeration date
02/18/2020
Last updated
02/18/2020
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