Individual
SAMANTHA BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
145 MICHIGAN ST NE STE 3100, GRAND RAPIDS, MI 49503-2563
(616) 954-9800
(616) 954-2116
Mailing address
5800 FOREMOST DR SE STE 300, GRAND RAPIDS, MI 49546-7062
(616) 954-9800
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
4704350687
MI
Other
Enumeration date
06/04/2019
Last updated
03/13/2020
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